ISSN:
1432-1076
Keywords:
Key words Insulin-dependent diabetes mellitus Childhood
;
Microalbuminuria
;
Puberty
;
Diabetic nephropathy
;
Abbreviations ADA American Diabetes Association
;
AER albumin excretion rate
;
CV coefficient of variation
;
IDDM type I (insulin dependent) diabetes mellitus
;
MA microalbuminuria (20
;
200 μg/min/1.73 m2)
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Microalbuminuria is generally accepted to be highly predictive of overt diabetic nephropathy which is the leading cause of end-stage renal failure and, consequently, of death in patients with type 1 (insulin-dependent) diabetes mellitus (IDDM). Its early identification and therapy are exceedingly important. We studied prospectively the occurrence of microalbuminuria (MA) in relation to puberty and its pubertal stages in 164 children and adolescent patients (83 girls and 81 boys) with IDDM. Analysing 100 healthy subjects, normal values for albumin excretion (range: 0–10.1 μg/min/1.73 m2) according to sex and the different pubertal stages were defined. No significant difference between the groups were noted and, therefore, 20 μg/min per 1.73 m2 (3 SD above the mean) was generally defined as cut-off for MA. Of the patients with IDDM studied, 20% (20 females and 12 males) developed persistent MA (22.1–448.2 μg/min/1.73 m2) during the study period of 8 years. The first manifestation of persistent MA was in 69% (13 females and 9 males) during stages of early and midpuberty; and in 28% (6 females and 3 males) at a late pubertal stage or at the end of puberty. The only child who developed MA before the onset of puberty (range: 23.5–157.4 μg/min/1.73 m2) was found to have dystopic kidney. Therefore, all patients with IDDM should be screened for MA regardless of diabetes duration, sex and level of diabetes control beginning at the very first stage of puberty and neither earlier nor after puberty as suggested by the American Diabetes Association.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01983401
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