title: The Improving Renal Complications in Adolescents With Type 2 Diabetes Through the REsearch (iCARE) Cohort Study: rationale and Protocol.
abstract: BACKGROUND
  Youth-onset type 2 diabetes is associated with a high burden of renal complications, culminating with end stage kidney disease in early adulthood. The establishment of relevant bioclinical determinants of albuminuria and ultimately progression of chronic kidney disease in youth is critically important to facilitate patient risk stratification and aid in the development of treatment targets and tailored prevention strategies. In response to the important gaps in knowledge, we created a prospective cohort study of youth with type 2 diabetes titled the Improving Renal Complications in Adolescents with Type 2 Diabetes through the REsearch (iCARE) Study.
  
  
  METHODS
  iCARE is a prospective observational cohort study of individuals with type 2 diabetes diagnosed prior to 18 years of age; the recruitment target was 400 patients. Phase 1 entailed a detailed phenotypic assessment of youth, including anthropometrics, biochemistry, 24-hour ambulatory blood pressure monitoring, overnight urine collections for albumin excretion, renal ultrasound and iohexol-derived glomerular filtration rate. Phase 2 of the study is an evaluation of psychological factors, including hair-derived cortisol; validated questionnaires for perceived stress, distress and resiliency; and a detailed evaluation of systemic and urine inflammatory biomarkers. Annual follow up is planned to assess temporal associations between clinical risk factors and renal outcomes, including progression of albuminuria.
  
  
  CONCLUSIONS
  This study will provide novel insight into the risk factors for albuminuria and progression of chronic kidney disease in youth with type 2 diabetes. New knowledge generated by this study will inform clinical care, and the infrastructure developed will provide a framework for future intervention studies.
authors.affiliation: Department of Pediatrics and Child Health, Section of Nephrology, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: adart@hsc.mb.ca.
authors.forename: Allison B
authors.initials: AB
authors.lastname: Dart
authors.affiliation: Department of Pediatrics and Child Health, Section of Endocrinology and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Brandy A
authors.initials: BA
authors.lastname: Wicklow
authors.affiliation: Department of Pediatrics and Child Health, Section of Endocrinology and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Sellers
authors.affiliation: Department of Pediatrics and Child Health, Section of Endocrinology and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Dean
authors.affiliation: Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Sayma
authors.initials: S
authors.lastname: Malik
authors.affiliation: Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Walker
authors.affiliation: Department of Community Health Sciences (Manitoba Centre for Health Policy), University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Dan
authors.initials: D
authors.lastname: Chateau
authors.affiliation: Department of Pediatrics and Child Health, Section of Nephrology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Tom D
authors.initials: TD
authors.lastname: Blydt-Hansen
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: McGavock
mesh_terms: D000293:Adolescent; D018660:Blood Pressure Monitoring, Ambulatory; D002170:Canada / Q000453:epidemiology; D002648:Child; D002985:Clinical Protocols; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D018450:Disease Progression; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D010641:Phenotype; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: albuminuria; albuminurie; cohort; cohorte; diabète de type 2; facteurs psychologiques; inflammation; psychological factors; type 2 diabetes