[Diseases of the kidney in children and adolescents with insulin-dependent diabetes mellitus].

In order to estimate kidney functions in 61 juvenile diabetes patients, the glomerular filtration rate, urinary extraction of albumin during night, and systolic and diastolic artery blood pressures were examined. The ratio of these variables in relation to the duration of the disease, the metabolic control of the disease, age, and the interrelation of these elements were analysed. The control group consisted of twenty healthy children. The glomerular filtration rate was increased in 59% of patients. It shows a positive correlation with the duration of the disease and the increased urinary extraction of albumin. Tolerable values were established in relation to the systolic artery blood pressure. Diabetic incipient nephropathy (microalbuminuria) marks the increased urinary extraction of albumin. The prevalence of microalbuminuria in the group of children with diabetes was 27.86%. It was significantly higher in patients with a longer duration of the disease, in older patients and in those with an increased glomerular filtration rate. Microalbuminuria shows a positive correlation with glycogenic hemoglobin and systolic and diastolic artery blood pressure values. Systolic and diastolic artery blood pressures correlate with the duration of the disease and the increased urinary extraction of albumin. The results suggest that glomerular hyperfiltration is the most precise indication of disturbed renal functions. The high percentage of its occurrence is found when the disease was diagnosed and these adverse manifestations are highly reversible. The increased urinary extraction of albumin indicates structural renal lesions. The results also indicate the tendency of an increase of artery blood pressure, especially the diastolic pressure, ten years after the occurrence of the disease. High blood pressure accelerates the progress of diabetic nephropathy. The authors are of the opinion that the examination of kidney functions both in children and adolescents with insulin-dependent diabetes is necessary for the early detection of renal lesions and for the application of an adequate therapy.