Screening for Diabetic Nephropathy in Teenage Diabetes

Abstract

Background: Diabetic nephropathy is the leading known cause of end-stage renal disease (ESRD). Epidemiological studies have demonstrated that diabetic nephropathy occurs in approximately one-third to one half of all diabetes and, today, diabetes is the most important cause of renal failure in the industrialized world. Recent studies have demonstrated that the onset and course of diabetic nephropathy can be ameliorated to a very significant degree by several interventions but these interventions would have their greatest impact if instituted at a point very early in the course of the development of this complication.Objective: To screen the problem of diabetic nephropathy in teenage patients with type I diabetes Mellitus (TIDM), by detection of Microalbuminuria (MA) which consider the best predictor of high risk for developing diabetic nephropathy.Patients and Methods: A cross-sectional design and a convenient sampling procedure were adopted to enroll 230 patients (118 males and 112 females) who met the inclusion criteria, from those attending the National Center for Treatment & Research of Diabetes in Al-Mustansirya Collage of Medicine-Baghdad during the period from the 1st of September 2006 to the end of December 2007. Micral test II was used to screen early morning (spot) urine samples for increased albumin excretion rate while the Schwartz formula made possible estimating the glomerular filtration rate (GFR) from serum creatinine and demographic characteristics. The results were used for evaluating the relationship between microalbuminuria and GFR. Some important risk factors including patient's age, disease duration, body mass index, and hypertension have also been evaluated with reference to the impact of hyperglycemia measured as the prevailing (HbA1c). -Conclusion: Micro-albuminuria manifested by increased urinary albumin excretion was encountered in 47.82% of our teenage DM patients showing significant association with hyperfiltration state, increasing level of HbA1c, and hypertension. But not gender or body mass index. Key words: Screening, Diabetic nephropathy, Teenage diabetes