Background:

Diabetes associated mortality is largely due to its long term complications. Diabetic nephropathy (DN) is one of the most serious long term complications of type 1 diabetes mellitus resulting from interaction of hyperglycemia and changes in hemodynamic such as blood pressure. It is characterized by development of proteinuria with a subsequent decline in glomerular filtration rate which progresses over a long period of time. DN occurs in stages with microalbuminuria as an early marker of progressive renal disease starting at pediatric age, with the prevalence of microalbuminuria ranging from 12% to 25% at 10 years of diabetes and from 30% to 40% after 20 years. Microalbuminuria can take different course such as regression or advance to more severe stages. Genetic modulates DN risk. Good glycemic control reduces the rate of long term complications such as DN. In the developed world, huge efforts are made to reduce the chronic complications of diabetes, yet in developing countries it is still a big challenge. Despite all this, there is limited information on chronic complications of diabetes among children and adolescents in sub-Saharan Africa and this makes their management difficult.

Aim:

The aim is to determine the prevalence of diabetic nephropathy and its association with glycemic control among children and adolescents with Type 1 Diabetes Mellitus receiving care at KCMC.

Methods:

It will be a cohort study which will be conducted at Pediatric Diabetic clinic from September 2016 to May 2017.Data will be collected by a structured questionnaire. Two urine samples will be collected from each patient at a three months interval.Serum creatinine will be done during the first study visit. Data will be analyzed using SPSS version 20. Descriptive statistics will be presented using frequency and proportions, means (SD), median (IQR) while odds ratio will be calculated to determine the associations.

Significance:

Heavy impact of childhood diabetes on morbidity and mortality later in life demonstrates the importance of assessing complication such as diabetic nephropathy and its burden. This early interval may provide a critical time frame for detection and intervention perhaps more successfully than later in the disease course. The knowledge from this study will assist in coming up with effective and targeted screening protocols and eventually improve our ix practice by increasing diagnosis for timely management to prevent progressive renal failure thus reducing management costs as well as the associated mortality.