Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India.
Interdisciplinary School of Health Sciences, Savitribai Phule University, Pune, India.
J Pediatr Endocrinol Metab. 2022 Mar 21;35(5):585-592. doi: 10.1515/jpem-2021-0644. Print 2022 May 25.
Children with type 1 diabetes (T1D) having diabetic nephropathy (DN) are at increased risk of developing end stage renal disease. The present study aimed to determine the prevalence of DN and its predictors in Indian children and youth with T1D.
This cross-sectional study included 319 children and youth (2.6-21 years) with T1D having disease duration of at least 2 years. Demographic data and laboratory findings were obtained using standard questionnaires and protocols. Diagnosis of diabetic nephropathy was based on albuminuria on two occasions within a period of 3 months.
The prevalence of DN in our study subjects was 13.4%. 7.5% subjects were known cases of diabetic nephropathy on treatment with enalapril. Hypertension was found in 14.3% subjects with DN in contrast to 4.1% without DN (p<0.05). Duration of diabetes and estimated glucose disposal rate were the important predictors of DN. Interestingly, of the 43 children with DN, 11.3% (n=8) were under 10 years age.
We found a high prevalence of DN in children and youth with T1D including in children under the age of 10 years. Early screening and timely intervention are required to retard the disease progression and avoid end stage renal disease.
患有 1 型糖尿病（T1D）的儿童发生糖尿病肾病（DN）的风险增加，处于终末期肾病的风险增加。本研究旨在确定印度 T1D 儿童和青少年中 DN 的患病率及其预测因素。
这项横断面研究纳入了 319 名 T1D 患儿和青少年（2.6-21 岁），其疾病持续时间至少为 2 年。使用标准问卷和方案获得人口统计学数据和实验室发现。DN 的诊断基于两次 3 个月内的蛋白尿。
我们研究对象中 DN 的患病率为 13.4%。7.5%的患者患有糖尿病肾病，正在接受依那普利治疗。DN 组中 14.3%的患者存在高血压，而无 DN 组中为 4.1%（p<0.05）。糖尿病病程和估计葡萄糖处置率是 DN 的重要预测因素。有趣的是，在 43 名患有 DN 的儿童中，有 11.3%（n=8）的年龄小于 10 岁。
我们发现 T1D 儿童和青少年中 DN 的患病率很高，包括年龄在 10 岁以下的儿童。需要进行早期筛查和及时干预，以延缓疾病进展并避免终末期肾病。
