Cystatin C — an Early Marker of Renal Damage in Children with Diabetes Mellitus Type 1

Authors

  • A.S. Senatorova Kharkiv National Medical University
  • Ye.G. Muratovа Kharkiv Regional Children’s Hospital, Kharkiv

DOI:

https://doi.org/10.22141/2224-0551.2.45.2013.88236

Keywords:

children, diabetes, kidney damage, cystatin C

Abstract

Purpose: study of cystatin C as an early marker of renal damage in children with diabetes mellitus (DM) type 1.
Methods. We examined 83 patients with diabetes mellitus type 1. Depending on the duration of the disease, patients were divided into 3 groups: 1st — with DM duration of 1–2 years, 2nd — 2–5 years, 3rd — more than 5 years after the onset of the disease. The control group consisted of 10 healthy children.
Results. The maximum values of glomerular filtration rate, reflecting the phenomenon of intraglomerular hypertension, had been observed predominantly among patients of 2nd and 3rd groups. Stable and diagnostically significant (≥ 30 mg/day,
III stage diabetic nephropathy) microalbuminuria has been detected in patients with diabetes duration more than 5 years. In patients of all groups in some cases significant microalbuminuria has been detected, but average indices were close to diagnostically significant. Increased excretion of glycosaminoglycans has been noted in 75 % of patients in the first group, 53.8 % — second group and in 52.1 % of patients in the third group of observations. There was a significant difference of cystatin C concentration in the urine of children with DM from the first group and the control group (p =0.03), between patients in second group and the control group (p = 0.003), between patients in third group and the control group (p = 0.003). Significant variability of this parameter was observed in children with DM duration of 1 to 2 years. The highest cystatin C median in urine was recorded in children from second group, which indicates a stable lesion of tubular apparatus of the kidney already in the second year of DM course. Moderate negative correlation was observed between Dopplerographic parameters of renal blood flow and cystatin C level, i.e. with an increase in cystatin C excretion, depletion of blood flow in main arteries is being detected.
Conclusions. 1. Kidney damage in DM has been observed on the first year of the disease, with dominance of dysfunction of tubular apparatus, and cystatin C is a highly informative and stable early marker of renal dysfunction. 2. Early kidney damage in children with type 1 DM is diagnosed when cystatin C level is above 21.9 ± 1.4 ng/ml. 3. Additional symptoms for early kidney damage are increased excretion of glycosaminoglycans, hypoperfusion at renal main arteries, reduced glomerular filtration rate.

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References

Вельков В.В. Цистатин С — точный индикатор скорости клубочковой фильтрации и ранний маркер преэклампсии // Лаборатория. — 2010 — № 10. — С. 18-22.

Дедов И.И. Тезисы докладов Всероссийского съезда эндокринологов. — М., 1996. — 5 с.

Михалева Л.Л., Золотавина М.Л., Хаблюк В.В. Цистатин С — надежный биохимический индикатор нарушения фильтрационной функции почек у детей // Современные проблемы науки и образования. — 2012. — № 5. Электронный ресурс: www.science-education.ru/105-7010 (дата обращения: 20.12.2012).

Омарова А.С. Функциональные нарушения почек у детей при мочекаменной болезни // Вестник КАЗНМУ. — 2012, январь. Электронный ресурс: http://kaznmu.kz/press/2012/01/27/

Папаян А.В., Архипов В.В., Береснева Е.А. Маркеры функции почек и оценка прогрессирования почечной недостаточности // Терапевтический архив. — 2004. — Т. 76, № 4. — С. 83-90.

Сенаторова А.С., Караченцев Ю.И., Кравчун Н.А. Сахарный диабет: от ребенка до взрослого. — Х.: ХНМУ, 2009. — 260 с.

Аndrej S. Krolewski, James H. Warram. Serum concentration of Cystatin C and Risk of End-Stage Renal Disease in Diabetes // Diabetes Care. — 2012. Электронный ресурс: http://care.diabetesjournals.org/content/early/2012/07/27/dc11-2220

Published

2022-02-25

How to Cite

Senatorova, A., & Muratovа Y. (2022). Cystatin C — an Early Marker of Renal Damage in Children with Diabetes Mellitus Type 1. CHILD`S HEALTH, (2.45), 74–77. https://doi.org/10.22141/2224-0551.2.45.2013.88236

Issue

Section

Clinical Pediatrics

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