Early predictors of kidney damage in children and adolescents with type 1 diabetes mellitus

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Abstract

Background. This article presents observations of the hyperglycemic state with kidney damage in children and adolescents. Type 1 diabetes mellitus (DM1) is caused by genetic defects that are inherited in an autosomal dominant manner, so there is usually more than one case of this pathology in the families of patients.

Objective. Determination of the structure of kidney pathology and substantiation of the clinical and laboratory predictors of chronic kidney disease in children and adolescents with type 1 diabetes mellitus.

Material and methods. A retrospective analysis of case histories of 109 children and adolescents with DM1, with kidney damage and vitamin D deficiency was performed. Patients were divided into 2 groups: the main group - 75 patients with diabetic nephropathy (DN) and vitamin D deficiency, the control group included 34 patients with DN with normal vitamin D levels. Verification of the diagnosis of DN was carried out in a hospital and included: collection and evaluation of complaints, study of anamnesis, clinical examination of the patient, assessment of self-control by the glycohemoglobin level, measurement of blood pressure, laboratory examination - total protein, creatinine and blood urea levels, general urinalysis for the presence of proteinuria, 24-hour urinary albuminuria, glomerular filtration rate (GFR), ultrasound examination of the kidneys. All patients were consulted by a nephrologist and an endocrinologist.

Results. It was found that it is impossible to detect DN at the early stages, since albuminuria (the last reversible stage of DN) is recognized as an early method for diagnosing DN. In children at the early stages, correct and timely treatment with insulin therapy was carried out, which affected the prevention of the development of DN.

Conclusion. Thus, the simultaneous assessment of the main indicators - GFR and albuminuria - is necessary for the primary diagnosis of renal dysfunction, as well as for monitoring of therapy, rate of progression of the pathological process and determining the prognosis.

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About the authors

Amina B. Zeinebekova

Karaganda Medical University; Outpatient Clinic № 5

Author for correspondence.
Email: zeynebekova97@mail.ru
ORCID iD: 0000-0001-8949-3283

Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, General Practitioner at the Polyclinic № 5, Karaganda, Ministry of Health of the Republic of Kazakhstan

Kazakhstan, Karaganda; Karaganda

Aizhanna M. Umarova

Karaganda Medical University; CCDC "Hippocrates"

Email: zeynebekova97@mail.ru
ORCID iD: 0000-0003-3201-9040

Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan, Pediatrician at the CCDC "Hippocrates"

Kazakhstan, Karaganda; Karaganda

Dilera U. Usmanova

Karaganda Medical University

Email: zeynebekova97@mail.ru
ORCID iD: 0000-0001-9550-9819

Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan

Kazakhstan, Karaganda

Aidana M. Turkara

Karaganda Medical University

Email: zeynebekova97@mail.ru
ORCID iD: 0000-0001-6963-4747

Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan

Kazakhstan, Karaganda

Viktoria E. Kovalchuk

Karaganda Medical University

Email: zeynebekova97@mail.ru
ORCID iD: 0000-0002-8385-644X

Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan

Kazakhstan, Karaganda

Sandugash B. Dyussenova

Karaganda Medical University

Email: zeynebekova97@mail.ru
ORCID iD: 0000-0001-9667-0735

Dr. Sci. (Med.), Professor, Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan

Kazakhstan, Karaganda

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