Principles of early diagnosis of diabetic nephropaty in children
Now it is convincingly proved that at the initial stages of development ofdiabetic nephropathy in children with type 1 diabetes mellitus, provided that the adequate treatment is started early, this condition is reversible. Therefore, early diagnosis of this complication is extremely urgent. Objective. To substantiate the effectiveness of the prediction technique for the early diagnosis of diabetic nephropathy in children with type 1 diabetes mellitus. Materials and methods. 125 patients with type 1 diabetes mellitus (DM) aged 4 to 18 years, verified according to the ISPAD Consensus criteria (2009) were examined. Results and discussion. It is established that the use of the Schwarz method did not reveal intergroup differences. Determination of individual values of the glomerular filtration rate (GFR) for the level of cystatin C yielded different results. In diabetic nephropathy (DN), GFR declines in 100% of cases, whereas in the comparison group, hypoperfusion was detected only in 21.9% of cases (p <0.005). The correlation analysis of Spearman made it possible to establish significant links between the decline in GFR and a number of clinical features of patients with NAM. Conclusions. Riskfactors for development of ND in children with type 1 diabetes are: age over 15 years, duration of the disease for more than 10 years, the presence of associated complications, low growth, hypertension and dyslipidemia. For prediction and pre-clinical diagnosis of renal damage in children with NAM, it is recommended to use serum levels of cystatin C and GFR, calculated on the basis of this parameter.