Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction Type one diabetes mellitus (T1DM) incidence and prevalence showed a progressive increase over a period of 18 years among children aged from 0 to 18 years living in the Nile Delta region. Higher T1DM may lead to many complications, either acute or chronic.Chronic complications include nephropathy, retinopathy, neuropathy, stroke and cardiovascular diseases. Using a specific assay for albumin is a more sensitive technique. Recently, attention has been called to atypical presentations of diabetic nephropathy with dissociation of proteinuria from reduced kidney function .As a pleiotropic cytokine, tumor necrosis factor alpha (TNF-Ü ) exerts multiple effects and it can contribute to the development of diabetic nephropathy through several mechanisms, including reduction of the glomerular blood flow and glomerular filtration rate, vasoconstriction induced by increased endothelin-1 production, and disruption of the glomerular filtration barrier which is mediated by the interaction with the intercellular junctions and leads to proteinuria . The aim of our study is to evaluate the serum level of TNF-Ü as an early detector of diabetic nephropathy in children and adolescents with type T1DM

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