Table 2. Characteristics of Included Studies Reporting on the Prevalence of Albuminuria in Pediatric Type 2 Diabetes.
| Source | Country | Study design | Age at diagnosis, mean (SD), y | Age at study enrollment or measurement, mean (SD), y | Duration of diabetes, mean (SD), y | Cases, No. (%) | Sample size | Sex distribution, No. (%) | Racial group distribution, No. (%) | Cases by sex or racial group, No. (%) | Albuminuria definition | Prevalence of obesity, No. (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Albuminuria | ||||||||||||
| Hotu et al,78 2004 | New Zealand | CS | mean, 15; range, 11-19 | NR | NR | 7 (58) | 12 | M: 6 (50); F: 6 (50) | Maori/PI: 12 (100) | M: 4 (67); F: 3 (50); Maori/PI: 7 (58) | ACR ≥30mg/g | NR |
| Ettinger et al,42 2005 | United States | CS | NR | 15.0 (1.9) | 1.5 (1.0) | 10 (40) | 25 | M: 12 (46); F: 14 (54)a | H: 15 (58); NHB: 8 (31); other: 2 (7); multiracial: 1 (4)a | NR | AER ≥30mg albumin/24 h | NR |
| Maahs et al,16 2007 | United States | CS | All participants <20 | Age <12 y: 19 (5.1%); age ≥12 y: 355 (94.9%) | 1.9 (0.4-3.2)b | 83 (22.2) | 374 | M: 140 (37.4); F: 234 (62.6) | AA: 110 (29.4); AI: 92 (24.6); NHW: 71 (19.0); H: 64 (17.1); API: 25 (6.8); multiracial or other: 11 (2.9); unknown: 1 (0.2) | M: 29 (20.7); F: 54 (23.1); AA: 18 (16.4); AI: 33 (36); NHW: 9 (13); H: 15 (23); API: 6 (24); multiracial or other: 2 (18); unknown: 0 (0) | ACR ≥30mg/g | 266 (72.3)a |
| Unnikrishnan et al,45 2008 | India | CS | 16.2 (2.9) | 18.9 (4.9) | NR | 0 | 36 | M: 21 (58); F: 15 (42) | Indian: 36 (100)c | Indian: 0 | AER >500mg albumin/24 h | NR |
| Bell et al,46 2009 | United States | CS | All participants <20 | Age 10-14 y: 42 (41.6%); age ≥15 y: 59 (58.4%) | NR | 14 (13.9) | 101 | NR | NHW: 101 (100) | NHW: 14 (13.9) | ACR ≥30mg/g | 83 (79.0)a |
| Mayer-Davis et al,50 2009 | United States | CS | 10-14: 11.7 (1); ≥15: 15.1 (1.9) | 10-14: 81 (38.2%); ≥15: 131 (61.8%) | 10-14: 1.2 (0.7); ≥15: 2.6 (2.1) | 30 (14.1) | 212 | NR | AA: 212 (100) | AA: 30 (14.1) | ACR ≥30mg/g | NR |
| Kim et al,83 2010 | United States | CS | NR | 14.5 (3.0) | mean, 1.3; range, 0.0-2.1 | 22 (21.4) | 103 | M: 40 (38.8); F: 63 (61.2) | Pima Indian: 103 (100) | Pima Indian: 22 (21.4) | ACR ≥30mg/g | NR |
| Amed et al,52 2012 | Canada | CS | Canadian Aboriginal: 12.9 (12.4-13.4)d; White: 14.4 (13.8-15.1)d; other (African/Caribbean, Asian, H, Middle Eastern): 14.3 (13.7-14.9)d | Canadian Aboriginal: 12.9 (12.4-13.4)d; White: 14.4 (13.8-15.1)d; other (African/Caribbean, Asian, H, Middle Eastern): 14.3 (13.7-14.9)d | 0 | 32 (14.4) | 221 | M: 91 (41.2); F: 130 (58.8) | Canadian Aboriginal: 100 (45.2); White: 57 (25.8); other (African/Caribbean, Asian, H, Middle Eastern): 64 (29.0) | Canadian Aboriginal: 16 (16.7); White: 6 (10); other (African/Caribbean, Asian, H, Middle Eastern): 9 (14) | NR | 211 (95.3) |
| Amutha et al,53 2012 | India | CS | 16.1 (2.5) | 22.2 (9.7) | Age ≤5 y: 219 (59.5%); age >5 to ≤10 y: 67 (18.2%); age >10 to ≤15: 21 (5.7%); age >15 y: 61 (16.6%) | 85 (23.1) | 368 | M: 168 (45.7); F: 200 (54.3) | South Indian: 368 (100.0)c | South Indian: 85 (23.1) | ACR ≥30mg/g | NR |
| Holman et al,84 2015 | United Kingdom | CS | All participants >12 | All participants, >12 | NR | NR (23) | NR | NR | NR | NR | NR | NR |
| Sellers et al,85 2009 | Canada | RC | NR | NR | 0 | 26 (29) | 90 | M: 40 (45); F: 50 (55) | FN/Metis: 88 (98); other: 2 (2) | NR | ACR >3 mg/mmol | NR |
| Yafi,67 2019e | United States | RC | range, 8-15 | NR | NR | 3 (12) | 25 | M: 11 (44); F: 14 (56) | H: 15 (60); other: 10 (40) | NR | NR | NR |
| Yeow et al,68 2019 | Malaysia | RC | 14.3 (3.5) | 20.7 (3.7) | 6.5 (2.8) | 7 (29) | 24 | M: 10 (42); F: 14 (58) | Malay: 12 (50); Chinese: 11 (46); Asian Indian: 1 (4) | Asian: 7 (29) | M: ACR >2.5mg/ mmol, F: ACR >3.5mg/ mmol | 10 (42) |
| Curran et al,69 2020 | Australia | RC | All participants <10 | All participants, <16 | NR | 2 (18) | 11 | NR | PI: 11 (100) | PI: 2 (18) | NR | 11 (100) |
| Ruhayel et al,71 2010 | Australia | PC | 13.4 (9.2-17.4)a,d | M: 16.0 (13.6-18.2; F: 15.6 (11.7-19.8)a,d | M: 2.2 (0.0-7.8; F: 2.3 (0.1-7.4)a,d | 9 (45) | 20 | NR | NR | NR | ACR >3.5mg/ mmol | 23 (70)a |
| Schmidt et al,73 2012 | Germany and Austria | PC | 13.5 (3.4) | 15.3 (3.0) | NR | 170 (24.9) | 684 | M: 261 (38.2); F: 423 (61.8) | German/Austrian: 482 (70.5); other: 202 (29.5) | NR | NR | NR |
| Candler et al,81 2018 | United Kingdom and Republic of Ireland | PC | 14.3 (7.9-16.9)d | 14.3 (7.9-16.9)d | 0 | 3 (2.8) | 106 | M: 35 (33.0); F: 71 (67.0) | NHW: 47 (44.3); Asian/Asian-British: 36 (34.0); BACBB: 14 (13.2); other: 5 (4.7); uncertain: 4 (3.8) | NR | NR | 86 (81.1) |
| Dart et al,74 2019 | Canada | PC | All participants <18 | 15 (13.3-16.8)b | 2.3 (0.9-4.1)b | 47 (25.1) | 187 | M: 62 (33.2); F: 125 (66.8) | Indigenous: 179 (95.7); other: 8 (4.3) | NR | ACR >2mg/mmol | NR |
| Persistent albuminuria | ||||||||||||
| Yoo et al,86 2004 | Korea | CS | 12.8 (1.5) | 18.4 (4.3) | 5.5 (3.9) | 5 (23) | 22 | M: 8 (36); M: 14 (64) | Korean: 22 (100) | Korean: 5 (23) | AER >20 μg/min on samples 3 mo apart | NR |
| Farah et al,87 2006 | United States | CS | NR | range, 10-21 | mean, 1.8; range, <2-5 | 9 (27) | 33 | NR | NR | NR | ACR >30 mg/g on 2 samples within 3-6 mo | 29 (73)a |
| Copeland et al,15 2011 | United States | CS | range, 10-17 | 14.0 (2.0) | 0.7 (0.5) | 92 (13.0) | 704 | M: 247 (35.1); F: 457 (64.9) | H: 289 (41.1); NHB: 222 (31.5); NHW: 138 (19.6); AI: 43 (6.1); Asian: 12 (1.7) | M: 26 (10.6); F: 65 (14.3); H: 41 (14.1); NHB: 25 (11.2); NHW: 20 (14.6); AI: 3 (8) | ACR ≥30mg/g on 2 of 3 samples during 3-mo period | NR |
| Sellers et al,88 2016 | Canada | CS | All participants <18 | NR | NR | 50 (5.1) | 976 | NR | NR | NR | M: ACR >2mg/ mmol, F: ACR >2.8mg/ mmol on 2 occasions during 6-mo period | NR |
| Aulich et al,57 2019 | Australia | CS | NR | 15.1 (1.9) | 1.8 (0.3-3.3)b | 6 (30) | 20 | NR | NR | NR | AER ≥20 μg/min in ≥2 of 3 samples or mean ACR, M: ≥3.5 mg/mmol; F: ≥4 mg/mmol from 3 first morning collections | 24 (75)a |
| Khalil et al,58 2019 | Egypt | CS | 18.0 (2.0) | 19.8 (1.1) | 2.5 (2.0) | 0 (0) | 13 | M: 6 (46); F: 7 (54) | Egyptian: 0c | Egyptian: 0 | ACR ≥30mg/g on 2 samples within 3-6 mo | NR |
| Scott et al,59 2004 | New Zealand | RC | NR | mean, 19.6; range, 14-23 | 1.7 | 2 (15) | 13 | M: 7 (54); F: 6 (46) | Maori: 7 (54); European: 4 (30); PI: 1 (8); Asian Indian: 1 (8) | NR | M: ACR >2.5mg/mmol; F: ACR >3.5mg/mmol on ≥2 occasions | 13 (100) |
| Scott et al,62 2006 | New Zealand | RC | NR | 20.0 (0.4) | 3.0 (0.3) | 76 (72.4) | 105 | NR | Maori/PI/other: 66 (62.9); European: 39 (37.1) | NR | M: ACR >2.5mg/ mmol; F: ACR >3.5mg/ mmol on ≥2 occasions | 105 (100) |
| Dart et al,65 2014 | Canada | RC | 13.5 (2.2) | 13.5 (2.2) | 0 | 93 (27.1) | 342 | M: 129 (37.8); F: 213 (62.2) | NR | NR | ACR >3mg/mmol or AER >30mg/24 h on ≥2 of 3 measurements 1 mo apart | NR |
| Eppens et al,4 2006 | Australia | PC | 13.2 (11.6-15.0)a,b | 15.3 (13.6-16.4)a,b | 1.3 (0.6-3.1)a,b | 10 (28) | 36 | NR | NR | NR | AER ≥20 μg/min in ≥2 of 3 samples or ACR ≥2.5 mg/mmol | 36 (56)a |
| Jefferies et al,72 2012 | New Zealand | PC | mean, 12.9; range, 7.1-15.5 | NR | NR | 18 (35) | 52 | M: 17 (33); F: 35 (67) | PI/Maori: 47 (90); other: 5 (10) | NR | ACR ≥2.5 mg/mmol on ≥2 of 3 samples during 6-mo period | NR |
| Dart et al,74 2019 | Canada | PC | All participants <18 | 15 (13.3-16.8b | 2.3 (0.9-4.1)b | 57 (30.5) | 187 | M: 62 (33.2); F: 125 (66.8) | Indigenous: 179 (95.7); other: 8 (4.3) | M: 15 (24); F: 42 (33.6); Indigenous: 56 (31.3) | ACR >2mg/mmol on 2 of 3 samples during a 6-mo period | NR |
| Microalbuminuria | ||||||||||||
| Hotu et al,78 2004 | New Zealand | CS | mean, 15 (11-19 | NR | NR | 5 (42) | 12 | M: 6 (50); F: 6 (50) | Maori/PI: 12 (100) | M: 3 (50); F: 2 (33); Maori/PI: 5 (42) | ACR ≥30-300mg/g | NR |
| Ettinger et al,42 2005 | United States | CS | NR | 15.0 (1.9) | 1.5 (1.0) | 10 (40) | 25 | M: 12 (46); F: 14 (54)a | H: 15 (58); NHB: 8 (31); other: 2 (7); multiracial: 1 (4)a | NR | AER ≥30mg albumin/24 h | NR |
| Eppens et al,44 2006 | Western Pacific | CS | 12.0 (10.7-13.5)a,b | 14.9 (13.2-16.4)a,b | 2.3 (1.4-3.6)a,b | 20 (8.0) | 251 | NR | NR | NR | AER 30-300mg/24 h or >20 μg/min or ACR >2.5mg/mmol | 106 (32.0)a |
| Kim et al,83 2010 | United States | CS | NR | 14.5 (3.0) | mean, 1.3 (0-2.1 | 19 (18.5) | 103 | M: 40 (38.8); F: 63 (61.2) | Pima Indian: 103 (100.0) | Pima Indian: 19 (18.5) | ACR ≥30-300mg/g | NR |
| Amutha et al,53 2012 | India | CS | 16.1 (2.5) | 22.2 (9.7) | Age ≤5 y: 219 (59.5%); age >5 to ≤10 y: 67 (18.2%); age >10 to ≤15 y: 21 (5.7%); age >15 y: 61 (16.6%) | 54 (14.7) | 368 | M: 168 (45.7); F: 200 (54.3) | South Indian: 368 (100)c | South Indian: 54 (14.7) | ACR ≥30-299mg/g | NR |
| Zabeen et al,89 2016e | Bangladesh | CS | 13.0 (11.0-15.0)d | 13.0 (11.0-15.0)d | 0 | 14 (10.0) | 144 | NR | Bangladeshi: 144 (100)c | Bangladeshi: 14 (10.0) | ACR ≥30-300mg/g | NR |
| Nambam et al,90 2017 | United States | CS | All participants <21 | 16.0 (14.0-17.7)b | 2.0 (0.7-4.2)b | 36 (6.0) | 598 | M: 218 (36.5); F: 380 (63.5) | H: 329 (55.0); AA: 179 (30.0); NHW: 48 (8.0); other/multiracial: 42 (7.0) | NR | NR | 472 (85.0)a |
| Le et al,91 2013 | United States | RC | 13.8 (2.4)a | 14.2 (2.4) | NR | 11 (17) | 64 | M: 20 (31); F: 44 (69) | AA: 52 (81); NHW: 12 (19) | AA: 11 (21); NHW: 0f | ACR ≥30-299 mg/g | NR |
| Osman et al,64 2013 | Sudan | RC | Age <11 y: 3 (7.9%); age 11-18 y: 35 (92.1%) | NR | NR | 7 (18) | 38 | M: 17 (45); F: 21 (55) | Arab: 32 (84); multiracial: 4 (11); non-Arab: 2 (5) | NR | NR | 29 (76) |
| Haynes et al,66 2014e | Australia | RC | 13.3 (2.0)a | 13.3 (2.0)a | 0 | 11 (18) | 61 | NR | NR | NR | NR | 82 (60.7)a |
| Calagua Quispe et al,92 2015e | Peru | RC | 12.6 (2.3) | NR | 3.7 (2.4) | 9 (43) | 20 | M: 10 (50); F: 10 (50) | NR | NR | NR | NR |
| Newton et al,93 2015e | New Zealand | RC | range, 6.5-17 | All participants, <17 | NR | 6 (55) | 11 | NR | NR | NR | NR | 22 (96)a |
| Son et al,94 2015 | Korea | RC | NR | 15.4 (12.6-17.4)b | 0.9 (0.0-3.0)b | 8 (44) | 18 | M: 4 (22); F: 14 (78) | Korean: 18 (100)c | Korean: 8 (44) | ACR ≥30-300mg/g | NR |
| Yeow et al.,68 2019 | Malaysia | RC | 14.3 (3.5) | 20.7 (3.7) | 6.5 (2.8) | 7 (29) | 24 | M: 10 (42); F: 14 (58) | Malay: 12 (50); Chinese: 11 (46); Asian Indian: 1 (4) | Asian: 7 (29) | M: ACR >2.5mg/mmol, F: ACR >3.5mg/mmol | 10 (42) |
| Ruhayel et al,71 2010 | Australia | PC | 13.4 (9.2-17.4)a,d | M: 16.0 (13.6-18.2); F: 15.6 (11.7-19.8)a,d | M: 2.2 (0.0-7.8); F: 2.3 (0.1-7.4)a,d | 9 (45) | 20 | NR | NR | NR | ACR >3.5mg/mmol | 23 (70)a |
| Schmidt et al,73 2012 | Germany and Austria | PC | 13.5 (3.3) | 15.3 (3.0) | NR | 154 (22.5) | 684 | M: 261 (38.2); F: 423 (61.8) | German/Austrian: 482 (70.5); other: 202 (29.5) | NR | NR | NR |
| Persistent microalbuminuria | ||||||||||||
| Yoo et al,86 2004 | Korea | CS | 12.8 (1.5) | 18.4 (4.3) | 5.5 (3.9) | 4 (18) | 22 | M: 8 (36); M: 14 (64) | Korean: 22 (100) | Korean: 4 (18) | AER >20 μg/min on samples 3 mo apart | NR |
| Farah et al,87 2006 | United States | CS | NR | range, 10-21 | mean, 1.8; range, <2-5 | 9 (27) | 33 | NR | NR | NR | ACR >30mg/g on 2 samples within 3-6 mo | 29 (73)a |
| Copeland et al,15 2011 | United States | CS | range, 10-17 | 14.0 (2.0) | 0.7 (0.5) | 92 (13.0) | 704 | M: 247 (35.1); F: 457 (64.9) | H: 289 (41.1); NHB: 222 (31.5); NHW: 138 (19.6); AI: 43 (6.1); Asian: 12 (1.7) | M: 35 (14.3); F: 48 (10.6); H: 41 (14.1); NHB: 25 (11.2); NHW: 20 (14.6); AI: 1 (8) | ACR ≥30mg/g on 2 of 3 samples during 3-mo period | NR |
| Aulich et al,57 2019 | Australia | CS | NR | 15.1 (1.9) | 1.8 (0.3-3.3)b | 6 (30) | 20 | NR | NR | NR | AER ≥20 μg/min in ≥2 of 3 samples or mean ACR, M: ≥3.5 mg/mmol; F: ≥4 mg/mmol from 3 first morning collections | 24 (75)a |
| Scott et al,59 2004 | New Zealand | RC | NR | 19.6 range, 14-23 | 1.7 | 2 (15) | 13 | M: 7 (54); F: 6 (46) | Maori: 7 (54); European: 4 (30); PI: 1 (8); Asian Indian: 1 (8) | NR | M: ACR >2.5mg/mmol, F: ACR >3.5mg/mmol on ≥2 occasions | 13 (100) |
| Scott et al,62 2006 | New Zealand | RC | NR | 20.0 (0.4) | 3.0 (0.3) | 76 (72.4) | 105 | NR | Maori/PI/other: 66 (62.9); European: 39 (37.1) | NR | M: ACR >2.5mg/mmol, F: ACR >3.5mg/mmol on ≥2 occasions | 105 (100) |
| Dart et al,8 2012 | Canada | RC | 13.5 (2.2) | 14.9 (2.1) | 1.6 (1.5) | 92 (26.9) | 342 | M: 129 (37.8); F: 213 (62.2) | NR | NR | ACR ≥3mg/mmol or AER 30mg/24 h on 2 of 3 samples 1 mo apart | NR |
| Son et al,94 2015 | Korea | RC | NR | 15.4 (12.6-17.4)b | 0.9 (0.0-3.0)b | 5 (28) | 18 | M: 4 (22); F: 14 (78) | Korean: 18 (100)c | Korean: 5 (28) | ACR ≥30-300 mg/g at baseline and follow-up | NR |
| Eppens et al,4 2006 | Australia | PC | 13.2 (11.6-15.0)a,b | 15.3 (13.6-16.4)a,b | 1.3 (0.6-3.1)a,b | 10 (28) | 36 | NR | NR | NR | AER ≥20 μg/min in at least 2 of 3 samples or ACR ≥2.5 mg/mmol | 36 (56)a |
| Jefferies et al,72 2012 | New Zealand | PC | mean, 12.9; range, 7.1-15.5 | NR | NR | 18 (35) | 52 | M: 17 (33); F: 35 (67) | PI/Maori: 47 (90); other: 5 (10) | NR | ACR ≥2.5 mg/mmol on ≥2 of 3 samples during 6-mo period | NR |
| Macroalbuminuria | ||||||||||||
| Hotu et al,78 2004 | New Zealand | CS | mean, 15; range, 11-19 | NR | NR | 2 (17) | 12 | M: 6 (50); F: 6 (50) | Maori/PI: 12 (100) | M: 1 (17); F: 1 (17); Maori/PI: 2 (17) | ACR >300mg/g | NR |
| Eppens et al,44 2006 | Western Pacific | CS | 12.0 (10.7-13.5)a,b | 14.9 (13.2-16.4)a,b | 2.3 (1.4-3.6)a,b | 1 (0.6) | 247 | NR | NR | NR | AER >300mg/24 h | 106 (32.0)a |
| Kim et al,83 2010 | United States | CS | NR | 14.5 (3.0) | 1.3 (0-2.1)b | 3 (2.9) | 103 | M: 40 (38.8); F: 63 (61.2) | Pima Indian: 103 (100) | Pima Indians: 3 (2.9) | ACR >300mg/g | NR |
| Amutha et al,53 2012 | India | CS | 16.1 (2.5) | 22.2 (9.7) | Age ≤5 y: 219 (59.5%); age >5 to ≤10 y: 67 (18.2%); age >10 to ≤15: 21 (5.7%); age >15 y: 61 (16.6%) | 31 (8.4) | 368 | NR | South Indian: 368 (100)c | South Indian: 31 (8.4) | ACR >300mg/g | NR |
| Schmidt et al,73 2012 | Germany and Austria | PC | 13.5 (3.4) | 15.3 (3.0) | NR | 16 (2.4) | 684 | M: 261 (38.2); F: 423 (61.8) | German/Austrian: 482 (70.5); other: 202 (29.5) | NR | NR | NR |
| Persistent macroalbuminuria | ||||||||||||
| Yoo et al,86 2004 | Korea | CS | 12.8 (1.5) | 18.4 (4.3) | 5.5 (3.9) | 1 (5) | 22 | M: 8 (36); F: 14 (64) | Korean: 22 (100) | Korean: 1 (5) | AER >200 μg/min on samples 3 mo apart | NR |
| Dart et al,8 2012 | Canada | RC | 13.5 (2.2) | 14.9 (2.1) | 1.6 (1.5) | 16 (4.7) | 342 | M: 129 (37.8); F: 213 (62.2) | NR | NR | NR | NR |
Abbreviations: AA, African American; ACR, albumin-to-creatinine ratio; AER, albumin excretion rate; AI, American Indian; API, Asian–Pacific Islander; BACBB, Black/African/Caribbean/Black British; CS, cross-sectional; F, Females; FN, First Nations; H, Hispanic; NR, not reported; M, Males; NHB, Non-Hispanic Black; NHW, Non-Hispanic White; PC, prospective cohort; PI, Pacific Islander; RC, retrospective cohort.
a
Based on total study cohort instead of only patients examined for the specific comorbidity.
b
Median (interquartile range).
c
Racial group distribution assumed to match country of origin.
d
Median (range).
e
Abstract only.
f
Value estimated based on graph.