Muratova K. Early markers of renal damage in children with type 1 diabetes

The objective of the thesis is to improve the diagnosis of early kidney damage in children with type 1 diabetes mellitus basing on the study of renal regional hemodynamics indices of kidney function. Assymetric dimethylarginine in blood plasma, mitogen-activated protein kinase p-38 in leucocyte lysate, cystatine C in urine were considered to be specific markers of early renal damage. We have provided the first evidence for the utility of mitogen-activated protein kinase р-38 in leucocyte lysate, cystatine C in urine for early diagnostics of renal damage in type 1 diabetes mellitus in children. Early renal damage is diagnosed when the level of asymmetric dimethylarginine in plaasme comprises more than 0,28 mmol/l and mitogen-activated protein kinase р-38 more than 4,38 Un / ml in leucocyte lysate, cystatine C excretion with blood within the limits of 26-52,8 ng / ml. We determined diagnostic significance of early renal damage markers in children with diabetes mellitus, as early as during the second year from the onset of the disease. We identified statistically reliable interrelationship between peculiarities of renal functional state with ultrasonographic signs of renal damage, Dopplerographic indices of renal and regional hemodynamics with different duration of diabetes mellitus in children, which specifies pathogenic mechanisms of renal damage. We carried out statistical analysis of interrelationship between anamnestic and clinical data, biochemical, ultrasound and Dopplerographic indices which allowed to elaborate the first ever prognostic algorithm of early renal damage in type 1 diabetes in children with a high information content and reliablity