Risk Factors of Diabetic Nephropathy Among A Group of Iraqi Children with Type 1 Diabetes Mellitus

Background: Diabetic nephropathy is the major cause of end-stage kidney disease in patients with diabetes mellitus.
Objective: To identify risk factors for occurrence of Diabetic nephropathy among group of Iraqi children with type 1 diabetes mellitus.
Methods: A cross-sectional study was conducted at Department of Chemistry and Biochemistry, and department of Pediatrics, College of Medicine, Al-Nahrain University from November 2019 to April 2020. Total of 80 children with diabetic nephropathy were divided into two groups: 40 patients without diabetic nephropathy and 40 patients with diabetic nephropathy. Blood and urine samples were taken for biochemical tests.
Results: Each of age, duration of diabetes mellitus, fasting blood sugar and HbA1c were significantly associated with diabetic nephropathy. However, duration showed higher predictive value (OR = 18.69, 95% CI = 5.48-63.74, p<0.001). Very low-density lipoprotein (VLDL-c) was the most powerful lipid test as predictor for diabetic nephropathy (OR = 15.07, 95% CI = 3.98-57.1, p<0.001). Albumin-creatinine ratio was the most powerful renal function test predictor for diabetic nephropathy (OR = 107.6, 95% CI = 20.3-569.6, p<0.001). When all variables were entered in multivariate regression model, only 3 (out of 14) remained significantly associated with the development of diabetic nephropathy. Of those, albumin creatinine ratio >25 mg/g was the most powerful independent predictor (OR = 11.78, 95%CI = 7.45-42.82, p = 0.009). In contrast, estimated glomerular filtration rate, was a negative predictor of diabetic nephropathy (OR = 0.26, 95% CI = 2.79-18.93, p = 0.026). HbA1c level >9% was a positive predictor of diabetic nephropathy (OR = 4.15, 95% CI = 3.88-36.91, p value = 0.031).
Conclusion: Albumin creatinine ratio and estimated glomerular filtration rate, are the strongest predicting factors for development and progression of diabetic nephropathy in Iraqi children with type 1 diabetes mellitus.
Keywords: Diabetes mellitus, diabetic nephropathy, children, risk factors
Citation: Hammoud MS, Alawsi FAF, Ali SH, Baban RS. Risk factors of diabetic nephropathy among a group of iraqi children with type 1 diabetes mellitus. Iraqi JMS. 2023; 21(1): 88-98. doi: 10.22578/IJMS.21.1.9