Background: Diabetes mellitus is the most common childhood metabolic disease whose prevalence has been increasing worldwide in recent decades. Diabetic nephropathy is one of the most important chronic complications of both types of diabetes (type one and two), which seriously increases the morbidity and mortality of diabetes. The present study evaluated the epidemiology and risk factors of diabetic nephropathy in children with diabetes in the northwestern region of Iran.
Method: In this cross-sectional study, 80 diabetic children, 33 (41.3%) males and 47 (58.7%) females with a mean age of 16.69± 4.50 years at the time of assessment, have been identified, evaluated, and followed up in the endocrinology clinic of Tabriz Children's Hospital from 2000 to 2015. The patients were divided into two groups based on the presence or absence of micro- or overt albuminuria, and different variables were compared between the two groups to determine risk factors.
Results: The mean age at the diagnosis was 7.75 ± 3.69 and the mean duration of diabetes was 8.98± 4.07 years. Good glycemic control was presented in 19 (23.8%), microalbuminuria in 36 (45%), overt albuminuria in 1 (1.3%), and retinopathy in 5 (6.3%) of patients; 7 (8.8%) had hypertension. Chronic kidney disease was found to be stage I in 90% and stage II in 10% of the patients. There was a significant difference between cases with and without albuminuria in terms of age at the time of the study (p=0.003), duration of diabetes (p=0.02), and serum cholesterol level (p=0.04). Linear Regression test showed that «the age at diagnosis» has a significant ability to predict the incidence of albuminuria (p = 0.03).
Conclusion: Due to the significant frequency of poor glycemic control in children and adolescents and the high prevalence of albuminuria in them, it is recommended to evaluate the renal function in diabetic children, especially in older patients, those with longer duration of diabetes or poor glycemic control.