Nephropathy is serious microvascular complication of insulin-dependent diabetes mellitus (IDDM). Early detection of diabetic nephropathy by measuring some glomerular and tubular markers was our aim of this work. 75 IDDM patients (36 females and 39 males), aging from 4.9 to 18.2 years and having a mean duration of diabetes 6.9 years, were divided into 3 groups according to the duration, A (0-5years), B (5-10years) and C >10 years. 25 healthy subjects were selected as control D . All subjects were investigated for glycated haemoglobin (HbAIc), urinary albumin / creatinine ratio (ACR) and N-acetyl-beta-D-glucosaminidase (NAG). Serum samples for sialic acid, prorenine, nitric oxide (NO, as nitrite and nitrate), lipid profile, blood suger and kidney function were assessed. The ACR had significant higher values in diabetic groups (P< 0.01) than the control. It was correlated significantly with HbAIc, duration of diabetes, as well ae, serum values of sialic acid, prorenin, NO and serum lipids. The level of urinary NAG showed significant increase (P<0.01) between diabetic and control groups, also there was a significant positive correlation between NAG and other glomerular and tubular markers. We concluded that there is tubular dysfunction in the early stage of IDDM children ever before there is any clinical evidence of nephropathy, urinary ACR and NAG can be used as early markers of diabetic nephropathy, and they may also reflect glycemic control in such patients. |
