Document Detail

Pediatric aspects of diabetic kidney disease.
MedLine Citation:
PMID:  15822059     Owner:  NLM     Status:  MEDLINE    
Type 1 diabetes mellitus (DM1) commonly occurs in childhood, although many pediatric centers are now seeing more cases of type 2 diabetes (DM2). Kidney failure caused by either type of diabetes is uncommon during childhood, but these years of hyperglycemia contribute to long-term complications. All children with diabetes warrant screening of glomerular filtration rate, blood pressure, and urine albumin excretion. Screening should begin after 5 years of DM1 or at puberty. A similar screening strategy should start at the time of diagnosis of DM2. Atypical features such as dipstick positive proteinuria or active urine sediment may warrant referral to a nephrologist for evaluation, including biopsy. The first line of treatment in either form of diabetes is achieving the best glycemic control possible. Patients developing microalbuminuria or hypertension should receive antiangiotensin II drugs. Adult studies suggest blood pressure goals should be lower in diabetes than in the general population. Although direct evidence is not yet available in children, achieving blood pressure below the 90th percentile for age, height, and gender seems prudent. Longitudinal studies and new screening tests may allow detection of susceptible children earlier in the course of DM1 or DM2, perhaps allowing prevention of diabetic kidney disease.
Pascale H Lane
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Advances in chronic kidney disease     Volume:  12     ISSN:  1548-5595     ISO Abbreviation:  -     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-11     Completed Date:  2005-08-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  101209214     Medline TA:  Adv Chronic Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  230-5     Citation Subset:  IM    
Department of Pediatrics, University of Nebraska, Medical Center, Omaha, NE 68198, USA.
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MeSH Terms
Age Factors
Diabetes Mellitus, Type 1 / complications,  diagnosis,  physiopathology*,  therapy
Diabetes Mellitus, Type 2 / complications,  diagnosis,  physiopathology*,  therapy
Diabetic Nephropathies / diagnosis*,  etiology,  therapy*
Mass Screening
Grant Support

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