Evaluation and risk factors of microalbuminuria in children with type 1 diabetes in Aswan University Hospital

Abstract

Background Diabetic nephropathy is the major complication of diabetes and is one of the leading causes of end-stage renal disease. Early identification of nephropathy is crucial to slow down this process. Assessment of albuminuria is used as an early clinical marker for impaired kidney function. The aim of this study is to evaluate the magnitude of microalbuminuria (MA) in children with type 1 diabetes and determine the factors correlated to it. Patients and methods A cohort study that was carried out on diabetic children attained the endocrinology clinic in our hospital from August 2019 to October 2020. Children aged 6–18 years old with a history of 2 years of diabetes were subjected to history, examination, and investigation, including urea, creatinine, lipid profile, hemoglobin A1c, and 24-h urinary albumin were done twice. Statistical analysis used χ 2, Fisher exact, and independent Wilcoxon t test for comparison between groups. Spearman and Pearson's for correlations. Results The median (interquartile range) of MA in the first visit was 10 mg/24 h (6.15–20 mg/24 h) in the first visit versus 9.5 mg/24 h (4.9–23.55 mg/24 h) in the second visit, with an insignificant P value. The abnormal numbers of hemoglobin A1c in the first visit were 85.7 and 79.3% in the second visit; P value is 0.350. Children with abnormal MA were 13.2% in the first visit versus 20% in the second visit with only four patients having persistent MA. MA was positively correlated to the Tanner stage in the first visit to blood pressure, serum triglyceride, and Tanner stage in the second visit, and negatively correlated to high-density lipoprotein. Conclusion Most of our patients had uncontrolled diabetes with an increasing prevalence of MA over time.