Diabetic Nephropathy in Childhood and Adolescence (I) : Clinical Features

Ha, Tae-Sun

doi:2009.13.1.1

J Korean Soc Pediatr Nephrol > Volume 13(1); 2009 > Article

J Korean Soc Pediatr Nephrol 2009;13(1): 1-13. doi: https://doi.org/10.3339/jkspn.2009.13.1.1

소아청소년기 당뇨병성 신병증(I); 임상 소견을 중심으로

하태선

충북대학교 의과대학 소아과학교실

Diabetic Nephropathy in Childhood and Adolescence (I) : Clinical Features

Tae-Sun Ha

Department of Pediatrics, College of Medicine, Chungbuk National University

ABSTRACT

Type 1 diabetes mellitus commonly occurs in childhood and adolescence, although the prevalence of type 2 diabetes mellitus in these age groups is now being increased in the western world and Korea. Diabetic nephropathy developing in 15-25% of subjects with type 1 diabetes mellitus and in similar or higher percentage of type 2 diabetes mellitus patients is the leading cause of end-stage renal disease worldwide. Although prepubertal diabetic duration may contribute less to the development of microvascular complications than pubertal and postpubertal duration, diabetic nephropathy in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Type 1 diabetes is commonly associated with a period of hyperfiltration followed by the development of persistent microalbuminuria after as little as 7-10 years of type 1 diabetes. Microalbuminuria is associated with pathologic lesions that are so advanced as to overlap with those seen in patients with overt proteinuria and declining kidney function, therefore, microalbuminuria currently considered the best clinical indicator of overt diabetic nephropathy risk. This review covers the natural history and renal manifestations of diabetic nephropathy in children and adolescents.

Key words: Adolescence | Childhood | Diabetic nephropathy | Microalbuminuria