Introduction
Diabetic nephropathy is the leading cause of renal failure in developed and developing countries. Earlier, more sensitive and specific markers of kidney damage might help diagnose and treat diabetic nephropathy at an earlier stage to prevent the progression to renal failure.
 
Aim of the study
Is to detect early changes in glomerular basement membrane in children with type1 diabetes mellitus.
 
Patients and Methods
This study included 170 children, 120 with diabetes mellitus type1 and 50 apparently healthy children serving as controls. The study and control group were subjected to complete history taking, through clinical examination. They were also subjected to some laboratory investigations including renal function tests, glycosylated haemoglobin (HbA1c), urinary albumin excretion by detecting albumin creatinine ratio (ACR), glomerular filtration rate and urinary podocalyxin (U- PCX) by EIA.
 
Results
Our study showed that urinary podocalyxin in diabetic children and adolescents was significantly higher than the control group (P < 0. 000), and it correlated positively with glycosylated haemoglobin (HbA1c) and albuminuria (r = 0. 577 and P < 0. 02) and (r = 0. 554 and P < 0. 000). Our results showed that microalbuminuric children had highly significant U- PCX than normoalbuminuric ones.
 
Conclusion
We conclude that urinary podocalyxin could be more sensitive and specific marker of kidney damage than microalbuminuria and thus it could be a useful biomarker for detecting early diabetic nephropathy. Also, U-PCX correlate positively with HbA1c concluding that hyperglycaemic  state may cause glomerular damage in early stage of diabetic nephropathy and that duration of diabetes may not play a role in that process.