Early changes in renal hemodynamics in children with diabetes: Doppler sonographic findings

Purpose. Although clinically evident diabetes-related microvascular complications are extremely rare in childhood, early functional and structural abnormalities may be present a few years after the onset of the disease. Renal Doppler resistance index (RI) is widely used for the evaluation of blood flow in renal parenchymal diseases. This study was designed to investigate the possible alteration of intrarenal Doppler RI in children with diabetes compared with healthy children. Methods. The study was performed in 42 children with diabetes (age range, 6-18 years) and in 41 age-matched healthy controls, all having normal renal function. RI was measured with Doppler sonography in interlobular renal arteries. Results. RI values were significantly greater in children with diabetes than in age-matched healthy controls (0.64 +/- 0.03 versus 0.60 +/- 0.04, P < 0.035). RI correlated positively with HbA1c (P < 0.001, r = 0.42) and diabetes duration (P < 0.05, r = 0.39). Conclusion. Early changes in renal hemodynamics are detectable on Doppler sonography in children with diabetes without any evidence of renal dysfunction and may suggest a preclinical stage of diabetic nephropathy. (C) 2008 Wiley Periodicals, Inc.