Abstract: SA-PO466
AKI Biomarkers Associate with Risk for Diabetic Nephropathy
Session Information
- Pediatric Nephrology - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1600 Pediatric Nephrology
Authors
- Kremsdorf, Robin Amy, Brown University, Providence, Rhode Island, United States
- Topor, Lisa Swartz, Brown University, Providence, Rhode Island, United States
Background
Children with diabetes mellitus (DM) are at significant risk to develop diabetic nephropathy. While conventional therapies (glycemic control, treating microalbuminuria with ACE inhibition) can reduce this risk, other determinants of renal outcomes in children with DM are poorly understood. We measured urine biomarkers of acute renal tubular injury in children and young adults with DM to identify if these biomarkers correlate with traditional renal risk factors.
Methods
Subjects between the ages of 10-21 years were recruited from DM clinics. Inclusion criteria included Type 1 DM for 3 years or longer or Type 2 DM for any duration. Clinical data, blood samples, and urine samples were obtained. The urine biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM1), and liver fatty-acid binding protein (L-FABP) were measured. Linear regression was used to analyze the relationship between each biomarker and clinical parameters (age, duration of diabetes, gender, hemoglobin A1c, presence of microalbuminuria > 30 mg/g).
Results
Of 155 subjects, 64 (41%) were female, 109 (70%) where white, and 129 (83%) had Type 1 DM. Mean (standard deviation, SD) age was 15.5 (2.7) years. Mean (SD) hemoglobin A1c was 9.1% (1.7) in those with Type 1 DM and 7.9% (2.6) among those with Type 2 DM. NGAL was associated with female gender (43 ng/mL higher in females), higher KIM-1 associated with microalbuminuria (6047 pg/mL higher in the presence of microalbuminuria), and L-FABP associated with hemoglobin A1c (0.23 pg/mL lower for each 1% increase of HgbA1c). These associations persisted when the analysis was restricted to subjects with Type 1 DM.
Conclusion
Amongst children and young adults with DM, acute kidney injury biomarkers have baseline associations with known risk factors for diabetic nephropathy. It will be important to determine if these biomarkers are associated with clinically relevant endpoints in the future.
Funding
- Private Foundation Support