Possibilities of the diagnosis and prevention of diabetic nephropathy development in children with type 1 diabetes mellitus

Abstract

The rapid increase in the prevalence of type 1 mellitus (DM) has made the study of this pathology in children a priority. Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus and is characterized by damage to the kidney vessels, development of glomerulosclerosis and chronic renal failure in the future. The asymptomatic course of the disease in the early stages complicates the diagnostic and prophylactic actions. Microalbuminuria develops 5–7 years after diagnosis of diabetes and is not the main indicator of kidney damage in the early stages of DN. Biomarkers play an important role in early diagnosis, analysis of the progression of the pathological process and adequate treatment. The purpose of the review is to study potential early biomarkers of DN and their structural and functional cha­racteristics. For writing the article, a search was made on the Scopus and Web of Science databases. The review contains information about 13 markers of functional impairment of the glomerular tubular apparatus of the kidney. The consequences of activation of oxidative stress, inflammatory and fibrotic processes at the level of the glomerular and tubular kidney apparatus are presented. A cascade of metabolic disturbances was considered, the trigger factor of which is hyperglycemia. The correlations, the expediency of using markers in patients of different ages and with different durations of type 1 diabetes were revealed. The biomarkers presented are candidates for the panel of diagnostic markers for DN and an addition to the existing standards for diagnosing lesions of the tubulointerstitial apparatus of the kidneys in case of DM. Prevention of diabetic complications remains an urgent task for modern researchers.

Keywords

• review
• diabetes mellitus type 1
• children
• diabetic nephropathy
• biomarkers