Renal Doppler indices in diabetic children with insulin resistance syndrome
- 25 February 2010
- journal article
- Published by Hindawi Limited in Pediatric Diabetes
- Vol. 11 (7), 479-486
- https://doi.org/10.1111/j.1399-5448.2009.00628.x
Abstract
End-stage renal failure is still a leading cause of mortality among type 1 diabetes patients. Insulin resistance plays a larger role in type 1 diabetes disease process than is commonly recognized. Detection of diabetic nephropathy as early as possible currently offers the best chance of delaying or possibly preventing progression to end-stage disease. Renal resistive index (RI) and pulsatility index (PI), measured using renal Doppler ultrasonography, reflect intrarenal vascular resistance. The present work aimed at examining renal Doppler indices (RI and PI) in type 1 diabetic children and their relation to features of insulin resistance and other established parameters of early diabetic nephropathy as microalbuminuria. One hundred diabetic children with a mean age of 13.4 ± 2.9 yr and an average diabetes duration of (7.2 ± 2.5 yr) were included. Thirty healthy children served as controls. All renal Doppler indices were significantly higher in children with type 1 diabetes mellitus (p ≤ 0.01). The worst parameters were observed in children diagnosed with insulin resistance syndrome (IRS) (38%), hypertensive (12%), and obese (4%) children. Resistive index showed a significant correlation to blood pressure (r = 0.2, p = 0.04), waist-hip ratio (r = 0.5, p = 0.02), insulin dose (r = 0.2, p = 0.02) and estimated glucose disposal rate (r = -0.5, p = 0.01). No correlation was noted to microalbuminuria, HbA1c, or duration of diabetes. The present work concluded that renal Doppler indices are worse in diabetic children and particularly those with IRS. These children appear to be at graver risk for diabetic nephropathy. In these patients adding renal Doppler assessment to their work up, might diagnose diabetic nephropathy at a prealbuminuric stage.Keywords
This publication has 23 references indexed in Scilit:
- Early changes in renal hemodynamics in children with diabetes: Doppler sonographic findingsJournal of Clinical Ultrasound, 2008
- Serum and Urinary Nitrites and Nitrates and Doppler Sonography in Children With DiabetesDiabetes Care, 2006
- Insulin Resistance, Hyperinsulinemia, and Renal Injury: Mechanisms and ImplicationsAmerican Journal of Nephrology, 2006
- Insulin resistance in diabetic nephropathy — cause or consequence?Diabetes/Metabolism Research and Reviews, 2006
- Resistência à insulina e síndrome metabólica no diabetes melito do tipo 1Archives of Endocrinology and Metabolism, 2006
- Recent advances in diabetic nephropathyHeart, 2004
- The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and AdolescentsPEDIATRICS, 2004
- Microalbuminuria in diabetes mellitus Efficacy of a new screening method in comparison with timed overnight urine collectionJournal of Diabetes and its Complications, 2003
- Does Microalbuminuria Predict Diabetic Nephropathy?Diabetes Care, 2001
- Diabetic Glomerulopathy in Young IDDM PatientsHormone Research in Paediatrics, 1998