[Microalbuminuria as risk factor for nephropathy in children with insulin-dependent diabetes mellitus].
OBJECTIVE
To assess the prevalence of microalbuminuria (> or = 30 mg/24 h) in children with insulin dependent diabetes mellitus (IDDM).


METHODS
Retrospective.


METHODS
Department of Pediatrics, University Hospital, Free University of Amsterdam.


METHODS
Albumin excretion rate was assessed in 24-hour voiding volumes in 71 children, mean age 11.8 yrs (range 3.5-17.9; 27 boys and 43 girls). Mean duration of IDDM was 5.4 yrs (1.0-5.0). Patients with albuminuria were compared with patients without microalbuminuria. Results of angiotensin-converting enzyme inhibition (n = 4) are presented.


RESULTS
The prevalence of microalbuminuria was 16% (n = 11). In 7% (n = 5) the microalbuminuria was persistent; in 9% (n = 6) it was intermittent. The mean age of the children with microalbuminuria (14.0 years; 8.9-17.4) was significantly higher than the age of the children without this disorder (11.7 years; 3.5-17.9). Two prepubertal children had developed microalbuminuria. The group with microalbuminuria had a significantly higher age at onset of the disease (8.1 years; 1.9-13.0) than the group without microalbuminuria (5.8 jaar; 0.9-14.5). The daily dose of insulin in the group with microalbuminuria was significantly higher (1.15 U/kg; 0.6-1.56) than in the group without microalbuminuria (0.97 U/kg; 0.20-1.87). There was no correlation between microalbuminuria and the duration of the disease.


CONCLUSIONS
Microalbuminuria may exist as early as the prepuberal period, but is found more frequently in children with IDDM who have entered puberty. There is a correlation between microalbuminuria and the age which it develops, the age at onset of the IDDM and the daily dose of insulin. Secondary prevention of diabetic nephropathy with ACE inhibition appears to be possible.
Baak
M A
MA
Academisch Ziekenhuis Vrije Universiteit, afd. Kindergeneeskunde, Amsterdam.
Odink
R J
RJ
Delemarre-van de Waal
H A
HA
D000293:Adolescent; D000367:Age Factors; D000419:Albuminuria / Q000652:urine*; D002216:Captopril / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000652:urine*; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000652:urine*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D009391:Nephelometry and Turbidimetry; D012189:Retrospective Studies; D012307:Risk Factors
D002216:Captopril; D006442:Glycated Hemoglobin
Microalbuminurie risicofactor voor nefropathie bij kinderen met van insuline afhankelijke diabetes mellitus.