Diabetic nephropathy has been the subject of extensive study since the classic description of nodular glomerulosclerosis by Kimmelstiel and Wilson.1 A similar nephropathy has been recently described in prediabetic adults 2,3,4 further supporting the hypothesis that vascular abnormalities are an integral part of the diabetic diathesis. If this hypothesis is correct, one might expect to find the earliest and least complicated renal lesions in children. Percutaneous renal biopsies were therefore obtained in a group of diabetic and prediabetic children to define any existing nephropathy and to relate this to clinical and laboratory findings.
Patients, Materials, and Methods
Eleven diabetic and two prediabetic children attending the Louisiana State University Pediatric Metabolic Clinic at Charity Hospital in New Orleans were hospitalized for study. Included were 5 male siblings, the 3 oldest of whom were overtly diabetic; the 2 youngest, the prediabetics.All diabetic children in this clinic were managed by a