Microalbuminuria in children and adolescent with type 1 Diabetes mellitus attending the diabetic center of children welfare teaching hospital.

Abstract

Backgrounds: Despite advances in management of diabetes mellitus, it remains one of the major causes of morbidity and mortality, yet diabetic nephropathy is one of the main complications of diabetes mellitus. .Microalbuminuria is the beginning to the renal complications of diabetes mellitus; it is a significant index of early detection as well as monitoring the progression of diabetic nephropathy.                                                                                                                                        

Aim of the study: to estimate the presence of microalbuminuria as predictor for nephropathy among children and adolescent with type1 diabetes mellitus and to study the effect of various factors on incidence of microalbuminuria in these patients.                                                                                                                

Subjects and methods: this study was carried out in the Children Welfare Teaching Hospital/ Medical City over ten months period. Fifty patients with type 1 diabetes and fifty non-diabetic children matched for age and sex were included in the study as control group. History was taken, physical examination and investigations done for all subjects. Early urine samples were used to estimate albumin/creatinine ratio to detect microalbuminuria. Statistical analysis done using T test and chi square, P value < 0.05 regarded as statistically significant.                                                                            

Results: out of 50 patients with type 1 diabetes, 35 (70%) had microalbuminuria. There was significant association between presence of microalbuminuria and increasing age (P value 0.04), increasing duration of diabetes (P value 0.03) and glycemic control level(P value =0.04).Seven (46.6% ) patients with duration of  <5 years had microalbuminuria, all of them had onset of diabetes before puberty. There was no significant difference between diabetic patients and controls and between microalbuminuria +ve and -ve diabetic patients in regards to systolic and diastolic blood pressure, body mass index and glomerular filtration rate.                                                     

Conclusions: All patients with microalbuminuria had normal blood pressure, and normal glomerular filtration rate, so we can detect the patients early before they develop overt nephropathy, hypertension and impaired renal function. Some of our patients with duration of diabetes   < 5 years had microalbuminuria, all of them had prepubertal onset of diabetes.