Русский
Early predictors of kidney damage in children and adolescents with type 1 diabetes mellitus
DOI: https://dx.doi.org/10.18565/nephrology.2023.1.54-57
Zeinebekova A.B., Umarova A.M., Usmanova D.U., Turkara A.M., Kovalchuk V.E., Dyussenova S.B.
1) Karaganda Medical University, Karaganda, Kazakhstan; 2) Outpatient Clinic № 5, Karaganda, Kazakhstan; 3) CCDC "Hippocrates", Karaganda, Kazakhstan
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.
About the Autors
Amina B.Zeinebekova – 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. Address: Karaganda, Kazakhstan, 100000; e-mail: zeynebekova97@mail.ru. ORCID: https://orcid.org/0000-0001-8949-3283. Aizhanna M. Umarova – Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan, Pediatrician at the CCDC "Hippocrates", Karaganda. Address: Karaganda, Kazakhstan, 100012. ORCID: https://orcid.org/0000-0003-3201-9040.
Dilera U. Usmanova – Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan. Address: Karaganda, Kazakhstan, 100000. ORCID: https://orcid.org/0000-0001-9550-9819.
Aidana M. Turkara – Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan. Address: Karaganda, Kazakhstan, 100000. ORCID: https://orcid.org/0000-0001-6963-4747.
Viktoria E. Kovalchuk – Resident at the Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan. Address: Karaganda, Kazakhstan, 100000. ORCID: https://orcid.org/0000-0002-8385-644X.
Sandugash B. Dyussenova – Dr. Sci. (Med.), Professor, Department of Pediatrics and Neonatology, Karaganda Medical University, Ministry of Health of the Republic of Kazakhstan, Karaganda, Kazakhstan 100000. ORCID: https://orcid.org/0000-0001-9667-0735.
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