Allison B Dart1, Brandy A Wicklow2, Elizabeth A Sellers2, Heather J Dean2, Sayma Malik3, John Walker3, Dan Chateau4, Tom D Blydt-Hansen5, Jonathan M McGavock6. 1. Department of Pediatrics and Child Health, Section of Nephrology, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: adart@hsc.mb.ca. 2. Department of Pediatrics and Child Health, Section of Endocrinology and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada. 3. Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada. 4. Department of Community Health Sciences (Manitoba Centre for Health Policy), University of Manitoba, Winnipeg, Manitoba, Canada. 5. Department of Pediatrics and Child Health, Section of Nephrology, University of Manitoba, Winnipeg, Manitoba, Canada. 6. Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada.
Abstract
BACKGROUND: Youth-onset type 2 diabetes is associated with a high burden of renal complications, culminating with end stage kidney disease in early adulthood. The establishment of relevant bioclinical determinants of albuminuria and ultimately progression of chronic kidney disease in youth is critically important to facilitate patient risk stratification and aid in the development of treatment targets and tailored prevention strategies. In response to the important gaps in knowledge, we created a prospective cohort study of youth with type 2 diabetes titled the Improving Renal Complications in Adolescents with Type 2 Diabetes through the REsearch (iCARE) Study. METHODS: iCARE is a prospective observational cohort study of individuals with type 2 diabetes diagnosed prior to 18 years of age; the recruitment target was 400 patients. Phase 1 entailed a detailed phenotypic assessment of youth, including anthropometrics, biochemistry, 24-hour ambulatory blood pressure monitoring, overnight urine collections for albumin excretion, renal ultrasound and iohexol-derived glomerular filtration rate. Phase 2 of the study is an evaluation of psychological factors, including hair-derived cortisol; validated questionnaires for perceived stress, distress and resiliency; and a detailed evaluation of systemic and urine inflammatory biomarkers. Annual follow up is planned to assess temporal associations between clinical risk factors and renal outcomes, including progression of albuminuria. CONCLUSION: This study will provide novel insight into the risk factors for albuminuria and progression of chronic kidney disease in youth with type 2 diabetes. New knowledge generated by this study will inform clinical care, and the infrastructure developed will provide a framework for future intervention studies.
BACKGROUND: Youth-onset type 2 diabetes is associated with a high burden of renal complications, culminating with end stage kidney disease in early adulthood. The establishment of relevant bioclinical determinants of albuminuria and ultimately progression of chronic kidney disease in youth is critically important to facilitate patient risk stratification and aid in the development of treatment targets and tailored prevention strategies. In response to the important gaps in knowledge, we created a prospective cohort study of youth with type 2 diabetes titled the Improving Renal Complications in Adolescents with Type 2 Diabetes through the REsearch (iCARE) Study. METHODS: iCARE is a prospective observational cohort study of individuals with type 2 diabetes diagnosed prior to 18 years of age; the recruitment target was 400 patients. Phase 1 entailed a detailed phenotypic assessment of youth, including anthropometrics, biochemistry, 24-hour ambulatory blood pressure monitoring, overnight urine collections for albumin excretion, renal ultrasound and iohexol-derived glomerular filtration rate. Phase 2 of the study is an evaluation of psychological factors, including hair-derived cortisol; validated questionnaires for perceived stress, distress and resiliency; and a detailed evaluation of systemic and urine inflammatory biomarkers. Annual follow up is planned to assess temporal associations between clinical risk factors and renal outcomes, including progression of albuminuria. CONCLUSION: This study will provide novel insight into the risk factors for albuminuria and progression of chronic kidney disease in youth with type 2 diabetes. New knowledge generated by this study will inform clinical care, and the infrastructure developed will provide a framework for future intervention studies.
Authors: Jana L Slaght; Brandy Alexandra Wicklow; Allison B Dart; Elizabeth A C Sellers; Melissa Gabbs; Marylin Carino; Jonathan M McGavock Journal: BMJ Open Diabetes Res Care Date: 2021-05
Authors: Allison B Dart; Brandy Wicklow; Tom D Blydt-Hansen; Elizabeth A C Sellers; Sayma Malik; Dan Chateau; Atul Sharma; Jonathan M McGavock Journal: Can J Kidney Health Dis Date: 2019-04-21
Authors: Haifa Alfaraidi; Brandy Wicklow; Allison B Dart; Elizabeth Sellers; Jonathan McGavock; Lehana Thabane; M Constantine Samaan Journal: Sci Rep Date: 2021-04-27 Impact factor: 4.379