Background: Chronic kidney disease (CKD) was defined by structural or functional renal abnormalities, or an estimated glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m2. A child with CKD may develop many complications such as: anemia, poor growth and nutrition, bone and mineral disorders, cardiovascular complications, and complications of hemodialysis, and peritoneal dialysis.
Aim: Assessment of severity of renal impairment and staging of chronic kidney disease in type 1 diabetic children and adolescents using serum creatinine, renal ultrasound and renal scan.
Patients and Methods: This analytic cross sectional study was conducted on 41 children and adolescents having type 1 diabetes mellitus, aged 5 to 18 years old with duration of diabetes more than 5 years, presented at Pediatrics department, Suez Canal University Hospital, Ismailia, Egypt. Full medical history, thorough clinical examination, laboratory investigations including H A1c, serum creatinine, renal ultrasound and renal scanning were performed for assessment of chronic kidney damage.
Results: The mean age of patients was 13.9±3.03 years; 63.4% were males& 36.6% were females, The mean GFR of the studied group using radionuclear Scintigraphy was (66.1±12.08) ml/min /1.7m2 ; 14.6% of them were in stage I CKD with GFR more than 90 ml/min /1.73 m2 and 85.4% were stage II CKD . By using renal ultrasound, all of the studied population had normal renal ultrasound findings. Eighty three percent of the whole group were clinically asymptomatic. In this study, none of the studied group had elevated serum creatinine.
Conclusion: Renal Scintigraphy can be used as an accurate measure for assessment of GFR for early detection of renal dysfunction and chronic morbidity in type 1 diabetes mellitus in children and adolescents and can be used as an early predictor of chronic kidney disease better than using renal ultrasound or serum creatinine.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology