FEATURES OF CLINICAL MANIFESTATION AND WAYS TO SOLVE THE PROBLEM OF DIABETIC NEPHROPATHY IN CHILDREN

Diabetic nephropathy (DN) and its progression to chronic renal failure (CRF) have become an important issue of national health in Europe, the USA and Japan. In terms of the need for hemodialysis treatment or kidney transplantation, DM ranks first in the USA and shares 2nd and 3rd place in European countries. In the USA, the main contribution to the annual increase in the number of patients with CRF (8%) is made by patients with DM, estimated at 34% of all cases [14]. Until recently, most cases of CRF were identified with insulin-dependent diabetes mellitus (IDDM). The prevalence of DN and CRF in non-insulin-dependent diabetes mellitus (NIDDM) has not been sufficiently studied, since it is difficult to accurately determine the time of disease onset, and increased albumin excretion can be observed even with a short duration of the disease. This situation is gradually beginning to change, since it is increasingly difficult to ignore the growing number of patients and the cost of all types of medical care aimed at combating this complication of diabetes. Terminal renal failure in type 2 diabetes develops much less frequently than in type 1 diabetes (5-10% and 30-50% of cases, respectively). However, these patients make up 90% of the entire diabetic population, and CRF that develops as a result of DN is the second most common cause of death (after cardiovascular complications). The US National Foundation has published data showing that patients with type 2 diabetes now account for the same number of new cases of chronic kidney disease as patients with type 1 diabetes [1].