title: Risk factors for early onset of diabetic nephropathy in pediatric type 1 diabetes.
abstract: OBJECTIVE
  Diabetic nephropathy (DN) is a frequent complication in patients with long-standing type 1 diabetes mellitus (DM1). The objective of this study was to assess the prevalence of DN in DM1 patients diagnosed during childhood and its association with clinical and metabolic variables, such as age at diagnosis of DM1, glucose control, dyslipidemia, hypertension and the occurrence of diabetic retinopathy (DR).
  
  
  METHODS
  The medical records of 205 patients admitted to the Pediatric Endocrinology Division at the Hospital das Clinicas da Universidade Federal de Minas Gerais, in Belo Horizonte, Brazil, were analyzed. For the analysis of survival and prognostic factors, the Kaplan-Meyer method and the COX regression model were used.
  
  
  RESULTS
  The mean disease duration was 11.32 +/- 4.02 years and the mean age at diagnosis was 6.10 +/- 3.54 years. Microalbuminuria was present in 11.2% of them, proteinuria in 6.8% and end-stage renal disease (ESRD) in 2.9%. There was a significant association between the occurrence of microalbuminuria or proteinuria and poor glucose control (p=0.025 and p=0.005, respectively), higher LDL cholesterol levels (p=0.006 and p=0.004, respectively) and age greater than 6 years at diagnosis (p=0.049 and p=0.05, respectively). Proteinuria was also associated to the occurrence of DR (p=0.016).
  
  
  CONCLUSIONS
  Our data showed that the prevalence of DN was higher than expected in this young population studied, especially considering the most severe forms. Clinical and laboratory factors associated to ND were: poor long-term glucose control, higher levels of LDL-C, higher age at diagnosis and the occurrence of DR.
authors.affiliation: Medical School, Federal University of Minas Gerais (UFMG), Brazil.
authors.forename: Patrícia Paz Cabral de Almeida
authors.initials: PP
authors.lastname: Salgado
authors.forename: Ivani Novato
authors.initials: IN
authors.lastname: Silva
authors.forename: Erica Cristina
authors.initials: EC
authors.lastname: Vieira
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Simões e Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000419:Albuminuria / Q000209:etiology; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D003930:Diabetic Retinopathy / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011507:Proteinuria / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors