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Early signs of diabetic nephropathy in childhood

Cosimo Giannini, Angelika Mohn & Francesco Chiarelli

Diabetes represents the single largest cause of end-stage kidney failure in adults. Although diabetic nephropathy is an uncommon cause of kidney failure during childhood, there is clear evidence that the underlying events increase to progressive kidney injury begin during childhood and accelerate during puberty. This is of paramount importance taking into consideration the significant worldwide increasing in the incidence of Type 1 and Type 2 diabetes in youths. The characterization of the natural history, identification of risk factors and subclinical signs of renal complications in childhood is essential for the implementation of preventive and therapeutic strategies, with the aim of changing the course of renal complications in young subjects with diabetes. In this report, an overview of the natural history, main histological alteration and risk factors associated with diabetic nephropathy are described. Finally, we focus on the screening guidelines suggested for youth with diabetes.