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Early-onset microalbuminuria in children with type 1 diabetes in Kuwait.

Background and Aims: Kuwait has the third highest incidence rates of Type 1 Diabetes Mellitus (T1DM) in the world, which makes diabetic complications more likely. The aim of this study is to identify the prevalence of diabetic nephropathy among our pediatric population and its risk factors. Methods: A total of 302 TIDM patients <15 years of age diagnosed at Mubarak Al-Kabeer hospital from January 2008 to December 2015 were recruited. Their demographic, clinical and biochemical data were reviewed including age, duration of diabetes, gender, Blood pressure, HBA1c, serum creatinine, microalbuminuria (MA), macroalbuminuria and eGFR. Results: the Mean age of patients at diagnosis was 11.2 ± 3.6 years and the male to female ratio was 48:52. The duration of disease was <5 years in 65% and the mean serum creatinine was 42.2 ± 15.8 μmol/L and mean eGFR was 183.7 ± 54 mL/min/1.73 m2. A total of 17 out of 140 patients had MA (12.1%). The majority (66%) of albuminuric patients had the disease for less than 5 years. Macroabuminuria was reported in 1 patient (0.07%). Chronic kidney disease was not reported in any of the patients. Compared to normoalbuminuric patients, more female patients were Albuminuric (83%vs. 50%, P<0.01), had a significantly higher mean systolic blood pressure centiles (88.6 ± 5.9 vs. 76.7 ± 23.9, P<0.0001), higher mean diastolic blood pressure centiles (88.0 ± 5.2 vs. 69.4 ± 22.3, P<0.0001) and a higher mean HbA1c levels (13.8 ± 1.5% vs. 9.3 ± 2.0 P<0.0001). Conclusion: Early-onset MA and hyper filtration are common in T1DM patients in Kuwait. Involvement of pediatric nephrologists in the care of T1DM patients should be considered in an attempt to prevent progression of DN.

Author(s): Amal A Al-Eisa, Ayedh Al-Hajri, Sulaiman Al-Shuaib, Dalia M Al-Abdul Razzak, Iman Al-Basiri