Kidney Week

Abstract: SA-PO665

Association of Serum Free Cortisol and Kidney Function in Children and Adolescents with Type 1 Diabetes Mellitus

Session Information

• Pediatric Nephrology - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Sloan, Lance A., Texas Institute for Kidney and Endocrine Disorders, Lufkin, Texas, United States

Lance A. Sloan, MD, MS, FASN

• Sloan, Katia P., Texas Institute for Kidney and Endocrine Disorders, Lufkin, Texas, United States

Katia P. Sloan, PhD, RDN

• Chagas, Eduardo Fb, Universidade de Marilia Faculdade de Medicina e Enfermagem, Marilia, São Paulo, Brazil

Eduardo Fb Chagas, PhD

• Barbalho, Sandra M., Universidade de Marilia Faculdade de Medicina e Enfermagem, Marilia, São Paulo, Brazil

Sandra M. Barbalho, PhD

• Haber, Jesselina Fs, Universidade de Marilia Faculdade de Medicina e Enfermagem, Marilia, São Paulo, Brazil

Jesselina Fs Haber, MD

Background

The treatment of Type 1 Diabetes mellitus (DM1) has always been a challenge for health care professionals due to the difficulties of achieving good glycemic control. Poor glycemic control can result in hyperfiltration and the development of diabetic kidney disease. Cortisol plays an essential role in the body's metabolism and chronic elevation or dysregulation of cortisol levels can have adverse effects on renal function and glycemic control. Our objective was to investigate the association between serum free cortisol and renal function in children and adolescents with DM1

Methods

A cross-sectional observational study was conducted with 61 individuals of both sexes (6-19 years) diagnosed with DM1 for at least 12 months and with C-peptide values < 0.3ng/ml. Renal function was measured as glomerular filtration rate (eGFR) using CKiD equation. Serum albumin (g/dL), creatinine (mg/dL), urea (mg/dL), and free cortisol (µg/dL) were collected in the morning in a fasting state. An early morning urine sample was collected for urine albumin to creatinine ratio (uACR). A multiple linear regression was used to explore the effect of cortisol (independent variable) on the dependent variables (eGFR, Creatinine, urea, albumin, uACR) controlling the effect of the independent covariates (sex, age, BMI-z, HbA1C and length of diagnosis).

Results

Increases in Cortisol, length of diabetes, HbA1c and being female was associated with an increase in eGFR and possibly hyperfiltration. Age was associated with a reduction in the eGFR. A significant effect of serum cortisol and gender explained 13.6% (R²) of the creatinine variation and 19.0% (R²) of the urea variation. Increases in cortisol in males was associated with an increase in creatinine and increases in cortisol in females was associated with a decrease in urea. An increase in cortisol was positively associated with uACR and inversely related to serum albumin.

Conclusion

There is a direct relationship between cortisol, eGFR, and uACR in children and adolescents with DM1. Cortisol may be having an impact on renal function which in the long term could potentially play a role in the progression of kidney disease in this population.

Funding

• Private Foundation Support