{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:38:07Z","timestamp":1773189487245,"version":"3.50.1"},"reference-count":25,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":4573,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To determine the prevalence of macroalbuminuria and to describe the clinical and renal pathological changes associated with macroalbuminuria in a population of Canadian First Nation children and adolescents with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We conducted a retrospective chart review at a single tertiary care pediatric diabetes center, and a case series was constructed. We collected data on microalbuminuria (\u22653 mg\/mmol creatinine [26.5 mg\/g]) and macroalbuminuria (\u226528 mg\/mmol creatinine [247.5 mg\/g]), estimated glomerular filtration rate, renal pathology, and aggravating risk factors (poor glycemic control, obesity, hypertension, glomerular hyperfiltration, hypercholesterolemia, smoking, and exposure to diabetes in utero).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We reviewed 90 charts of children and adolescents with type 2 diabetes. A total of 53% had at least one random urine albumin-to-creatinine ratio \u22653 mg\/mmol (26.5 mg\/g). There were 14 of 90 (16%) who had persistent macroalbuminuria at or within 8 years of diagnosis of diabetes. Of these 14 subjects, 1 had orthostatic albuminuria and 3 had spontaneous resolution of albuminuria. A total of 10 had renal biopsies performed. There were 9 of 10 who exhibited immune complex disease or glomerulosclerosis, and none had classic diabetic nephropathy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This study suggests that the diagnosis of renal disease in children with type 2 diabetes cannot be reliably determined by clinical and laboratory findings alone. Renal biopsy is necessary for accurate diagnosis of renal disease in children and adolescents with type 2 diabetes and macroalbuminuria. The additional burden of nondiabetic kidney disease may explain the high rate of progression to end-stage kidney failure in this population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc08-1828","type":"journal-article","created":{"date-parts":[[2009,2,20]],"date-time":"2009-02-20T02:05:42Z","timestamp":1235095542000},"page":"786-790","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":43,"title":["Macroalbuminuria and Renal Pathology in First Nation Youth With Type 2 Diabetes"],"prefix":"10.2337","volume":"32","author":[{"given":"Elizabeth A.C.","family":"Sellers","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Manitoba, University of British Columbia, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom D.","family":"Blydt-Hansen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Manitoba, University of British Columbia, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather J.","family":"Dean","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Manitoba, University of British Columbia, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian W.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Manitoba, University of British Columbia, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia E.","family":"Birk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Manitoba, University of British Columbia, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm","family":"Ogborn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Manitoba, University of British Columbia, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2009,2,19]]},"reference":[{"key":"2022031219385360200_B1","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1016\/S0140-6736(05)60329-7","article-title":"Screening for type-2 diabetes in aboriginal children in northern Canada","volume":"352","author":"Dean","year":"1998","journal-title":"Lancet"},{"key":"2022031219385360200_B2","doi-asserted-by":"crossref","first-page":"524","DOI":"10.2337\/diacare.22.3.524b","article-title":"Hepatocyte nuclear factor-1 alpha G319S: a private mutation in Oji-Cree associated with type 2 diabetes","volume":"22","author":"Hegele","year":"1999","journal-title":"Diabetes 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