Factors AssociatedWith Microalbuminuria in 7,549 Children and AdolescentsWith Type 1 Diabetes in the T1D Exchange Clinic Registry

OBJECTIVEdTo examine factors associated with clinical microalbuminuria (MA) diagnosis in children and adolescents in the T1D Exchange clinic registry. RESEARCH DESIGN ANDMETHODSdT1D Exchange participants,20 years of age with type 1 diabetes$1 year and urinary albumin-to-creatinine ratio (ACR)measured within the prior 2 years were included in the analysis. MA diagnosis required all of the following: 1) a clinical diagnosis of sustained MA or macroalbuminuria, 2) confirmation of MA diagnosis by either the most recent ACR being$30 mg/g or current treatment with an ACE inhibitor (ACEI) or angio-tensin receptor blocker (ARB), and 3) no known cause for nephropathy other than diabetes. Logistic regression was used to assess factors associated with MA. RESULTSdMA was present in 329 of 7,549 (4.4%) participants, with a higher frequency associated with longer diabetes duration, higher mean glycosylated hemoglobin (HbA1c) level, older age, female sex, higher diastolic blood pressure (BP), and lower BMI (P # 0.01 for each in multivariate analysis). Older age was most strongly associated with MA among participants with HbA1c $9.5 % ($80 mmol/mol). MA was uncommon (,2%) among participants with HbA1c,7.5 % (,58 mmol/mol). Of those with MA, only 36 % were receiving ACEI/ARB treatment. CONCLUSIONSdOur results emphasize the importance of good glycemic and BP control