Childhood diabetes mellitus and early-onset kidney diseases later in life: a nationwide population-based matched cohort study

Abstract

Background The empirical evidence remains inconclusive for an association between diabetes mellitus (DM) in children and early-onset kidney disease later in life, and little is known about the effects of DM types (i.e., type 1 diabetes [T1DM] and type 2 diabetes [T2DM]) in childhood on type-specific kidney diseases. We aimed to evaluate the association of childhood DM with overall and type-specific early-onset kidney diseases later in life. Methods The population-based matched cohort study included 9356 individuals with DM (T1DM: 8470, T2DM: 886) diagnosed in childhood (< 18 years) who were born between 1977 and 2016, and 93,560 individuals without DM matched on sex and year of birth in Denmark. The main outcomes were overall and type-specific early-onset kidney diseases. The follow-up period of all included participants was from the date of DM diagnosis in the exposure group until the first diagnosis of kidney disease, emigration, or 31 December 2018, whichever came first. Results During a median follow-up of 13 years, children with DM had a 154% increased risk of early-onset kidney diseases than children without DM (adjusted hazard ratios 2.54, 95% confidence intervals 2.38–2.72), and T1DM (2.48, 2.31–2.67) and T2DM (2.75, 2.28–3.31) showed similar results. Children with DM also had a higher risk of multiple specific kidney diseases including glomerular diseases, renal tubulo-interstitial diseases, renal failure, and urolithiasis. The risks of type-specific kidney diseases including glomerular diseases and renal failure tended to be higher for children with T2DM (glomerular diseases: 5.84, 3.69–9.24; renal failure: 14.77, 8.53–25.59) than those with T1DM (glomerular diseases: 3.14, 2.57–3.83; renal failure: 8.24, 6.66–10.20). Conclusions Children with DM had a higher increased risk of early-onset overall and specific kidney diseases later in life. Early prevention and treatment of both T1DM and T2DM in childhood may significantly reduce the risk of kidney diseases later in life.

Childhood Obesity: Insight into Kidney Involvement

“…In addition, diabetic children have an increased risk of other specific kidney diseases, including tubulo-interstitial and glomerular diseases, urolithiasis, and renal failure. The risk of developing these conditions tends to be higher in children with type 2 DM than in those with type 1-DM [32]. A consistent association has been demonstrated between increased BMI in adolescents and the development of ESRD from diabetic and nondiabetic causes.…”

“…Notably, bariatric surgery has consistently demonstrated its ability to reduce the prevalence of metabolic syndrome [31]. In a study with a median follow-up of 13 years, children with DM had a 154% increased risk of early-onset kidney disease compared with their counterparts without DM [32]. In addition, diabetic children have an increased risk of other specific kidney diseases, including tubulo-interstitial and glomerular diseases, urolithiasis, and renal failure.…”

Chronic kidney disease in patients with long-term type 1 diabetes mellitus

“…В Норвегии общая частота тХБП среди детей с СД1, диагностированным в возрасте 0-5 лет и 5-9 лет, была ниже, чем в 10-14 лет [17]. По данным датского регистра СД, дети более старшего возраста с СД1, диагностированным в возрасте 6-17 лет (по сравнению с более маленькими детьми с диагностированным СД1 в возрасте 0-5 лет) и дети с большей продолжительностью СД1 (по сравнению с более короткой продолжительностью СД1) чаще имели ХБП как в целом, так и в рамках диабетической нефропатии [18]. В нашем исследовании возраст дебюта СД1 6-17 лет повышал риск достижения тХБП и трансплантации vs возраст дебюта >18 лет (ОШ=2,4; 95% ДИ 1,22-5,022; р=0,012).…”

Intrarenal Resistive Index and Kidney Volume: Key Indicators of Early Diabetic Kidney Disease in Youth-Onset, Long-Duration Type 1 Diabetes

“…Moreover, su cient evidence reveals that diabetes diagnosed during childhood often leads to a more aggressive clinical course compared to when its onset in adulthood. Individuals with youth-onset diabetes tend to exhibit lower responsiveness to current interventions, faster loss of beta-cell function, increasing insulin resistance, and rapid development of albuminuria and end-organ complications, including kidney failure [11][12][13][14]. A nationwide retrospective cohort study conducted in Israel found that both childhood-onset T1D and T2D signi cantly increase the risk of ESRD [hazard ratios 36.4 (95% CI 28.3-46.9) and 19.3 (95% CI 9.6-38.8), respectively], compared to the non-diabetic population [11].…”