ESPN 51th Annual Meeting

ESPN 2018


 
Evaluation of Antiproteinuric Treatment in Adolescents with Type 1 Diabetes Mellitus and Microalbuminuria
SEÇIL ARSLANSOYU ÇAMLAR 1 HALE ÜNVER TUHAN 1 KORCAN DEMIR 1 ALPER SOYLU 1 AYHAN ABACI 1 ECE BÖBER 1 SALIH KAVUKCU 1

1- DOKUZ EYLÜL UNIVERSITY MEDICAL FACULTY
 
Introduction:

Microalbuminuria is the earliest sign of nephropathy in diabetes mellitus. RAA system suppression by ACE inhibitors may reduce microalbuminuria. However, there are no studies in childhood to evaluate the efficacy of these drugs in treatment of type 1 diabetes mellitus (T1DM). We aimed to investigate the characteristics and treatment responses of patients under the age of 18 who were diagnosed with T1DM and microalbuminuria.

Material and methods:

Medical records of the patients were retrospectively evaluated for gender; birth weight; family history of diabetes mellitus, hypertension, dyslipidemia, kidney disease; age at diagnosis; accompanying non-renal complications (retinopathy and neuropathy); anthropometric data; blood pressure; puberty stage; laboratory data (BUN, creatinine, creatinine clearance, serum lipids, microalbuminuria, HbA1c); type and duration of antiproteinuric treatment; and response to treatment.

Results:

The files of 265 patients with T1DM of at least 5 years duration were retrospectively scanned. Eleven patients (8 female) with microalbuminuria were evaluated. Age at diagnosis of T1DM was 7.2±4 years. The mean follow-up period after detection of microalbuminuria was 43 months (12-120). Seven patients (64%) were pubertal in the period when microalbuminuria was detected. Neuropathy was detected in one case while no patient developed retinopathy during the follow-up period. Four patients received captopril (0.7 mg/kg/day) and 7 patients received enalapril (0.1 mg/kg/day). Microalbuminuria was controlled in 7 cases with these treatment. In three cases, an increase in drug doses was needed, and in another case, angiotensin receptor blocker (losartan, 0.6 mg/kg/day) was added to control microalbuminuria. It was observed that 91% of the patients (n = 10) complied with the treatment.

Conclusions:

 RAAS inhibitors are effective in treatment of microalbuminuria in childhood T1DM patients and the compliance with treatment is high.