Clinical and epidemiological characteristics of diabetic nephropathy in children and adolescents in Moscow with insulin-dependent diabetes mellitus

A total of 166 patients (72 males and 94 females) with insulindependent diabetes mellitus (IDDM) aged 5 to 21 years with disease duration of 1 to 18 years were examined in order to assess the clinical picture and epidemiology of diabetic nephropathy (DN) in children and adolescents in Moscow. Microalbuminuria (MAU)*was the criterion of DN. DN was diagnosed in 75 (45.7%) of patients: in 64 (85.3%) at the MAU stage and in 11 (14.6%)) at the stage of proteinuria. There were no cases with the nephrotic syndrome or chronic renal insufficiency. The minimal duration of IDDM in adolescents with MAU was about 2 years, in those with proteinuria about 5 years. All patients with DN were pubertal or postpubertal. The incidence of DN did not depend on the sex, age, or pubertal status. DN risk factors in these patients were chronic hyperglycemia, total and prepubertal duration of diabetes, hereditary predisposition to arterial hypertension, and lipid disorders. Therefore, prepubertal children with disease duration of 5 years and adolescents with disease duration of 1 year since IDDM manifestation are to be screened for DN.