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The combination of serum cystatin C, doppler renal resistance indeks and kidney injury molecule-1 in early detection of diabetic kidney disease in children with diabetes mellitus type 1

Objective: Diabetic kidney disease is the leading cause of end-stage renal disease. Regression to normoalbuminuria in already albuminuric children calls into question albuminuria as an early indicator of diabetic kidney disease development. The aim of this study is to develop a clinically useful model based on the association of serum cystatin C, Doppler renal resistance index and kidney injury molecule-1 in urine with standard indicators of renal function in order to determine the optimal model for early detection of diabetic kidney disease. Methods: The study included 75 children with type 1 diabetes , normoalbuminuria and normal renal function aged 10-18 years, and 75 healthy children in the control group. In both groups, we determined serum cystatin C, KIM- 1 in urine, renal resistance index, lipidogram, thyroid hormones, serum creatinine, anthropometric parameters, blood pressure , glycated hemoglobin, estimated glomerular filtration rate, serum uric acid , urine albumin / creatinine ratio , and degree of pubertal development . Results: The results suggest that RI and urinary KIM-1 are higher in patients with T1D compared to the control group. In this study, RI is higher in affected children and is useful for assessing early hemodynamic changes in the preclinical phase of early renal impairment. Dyslipidemia, higher values of serum creatinine and insulin dose are associated with the increased risk of developing microalbuminuria and diabetic kidney disease.

cystatin C, KIM 1, renal resistance index, type 1 diabetes mellitus, children

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