Microalbuminuria in Children and Adolescents With Type 1 Diabetes Mellitus

Abstract

Diabetic nephropathy is the most important cause of increased morbidity and premature mortality in patients with type 1 diabetes mellitus. Detection of microalbuminuria helps to carry out early interventions to halt the progression of early stages of diabetic nephropathy to advanced renal disease. In this study the albumin: creatinine ratio was estimated in 70 children and adolescents with type 1 diabetes mellitus and 74 non-diabetic subjects attending Basrah Maternity and Children Hospital over one-year period (from the first of June 2001 till the end of May 2002), their ages ranged from 16 month-18 year. Albumin: creatinine ratio on early morning urine samples, HbA1C, blood pressure measurements and growth measures were recorded. Microalbuminuria (albumin: creatinine ratio 30-300mg/g) was present in 41.42% of patients with type 1 diabetes mellitus, while macroalbuminuria (albumin: creatinine ratio > 300mg/g) was detected in one patient (1.42%). Factors associated with a raised albumin: creatinine ratio compared with normoalbuminuric patients (albumin: creatinine ratio < 30 mg/g) with type 1 diabetes mellitus include longer duration of diabetes mellitus (P-value < 0.01), poor glycemic control reflected by raised HbA1C (P-value <0.001), and older age of diabetic patients (P-value <0.05). Microalbuminuria was not associated with body mass index, gender and systolic and diastolic blood pressure. These results stress the need for routine monitoring of diabetic patients for microalbuminuria and the importance of improved glycemic control in these patients.