INCREASED RENAL RESISTIVE INDEX AS A MARKER OF EARLY STAGE OF DIABETIC NEPHROPATHY IN NORMOALBUMINURIC CHILDREN WITH TYPE 1 DIABETES MELLITUS.

Abstract

This study aimed to compare the renal resistive index (RI) as an early marker of renal damage between normoalbuminuric children with type 1 diabetes mellitus (T1D) and normal age-matched controls. A total of 76 children with T1D (aged 10-18 years) and 76 healthy age-matched controls were enrolled. Anthropometric parameters, blood pressure, glycated hemoglobin (HbA1c), serum creatinine (sCr), estimated glomerular filtration rate (eGFR), serum uric acid (SUA), urine albumin/creatinine ratio (ACR), and degree of pubertal development were determined in all participants. RI was measured using Doppler ultrasound in both groups. The T1D group had lower sCr and SUA values and higher ACR and mean RI values than the control group. Using the expectation-maximization method, 2 clusters of T1D patients were identified. Cluster 2 with higher RI values, eGFR and HDL cholesterol was more prone to albuminuria and could carry worse prognosis. In conclusion, renal RI is increased in the hyperfiltration phase of diabetic nephropathy in children with T1D. Renal RI could be helpful as a marker for diagnosing diabetic nephropathy in the early preclinical course of the disease in normoalbuminuric children with T1D.