Familial factors determine the development of diabetic nephropathy in patients with IDDM.

摘要: To evaluate familial factors in the development of diabetic nephropathy insulin-dependent diabetes mellitus (IDDM) we examined concordance for families with multiple IDDM siblings. Families (n = 110) were identified through Joslin Clinic patients (probands) a sibling having IDDM. be eligible, probands' and siblings' ages at diagnosis less than 21 years, duration was more 15 years probands 10 Mean post-pubertal 23 siblings 125). Nephropathy history determined by medical record review deceased those persistent proteinuria or end-stage renal disease to ascertain date onset proteinuria. For without documented nephropathy, albumin/creatinin ratio measured urine samples. The cumulative incidence according life-table analysis. combined, advanced after 30 35%, but risk varied proband's status. 25 (post-puberty) 71.5% if proband had only 25.4% did not (p < 0.001). A difference nearly 50% siblings, depending upon status, is consistent major gene effect that predisposes an individual develop nephropathy.