Diabetic woman with massive proteinuria and acute renal failure

NEPHROTIC SYNDROME and renal insufficiency are frequent accompaniments of diabetic nephropathy. 1,2 However, a second disease superimposed on diabetic nephropathy is of concern, especially if the proteinuria is massive or renal failure is deemed to be acute. Primary glomerulopathies associated with diabetic nephropathy, although uncommon, have been reported previously, and any number of second diseases can affect the diabetic kidney.(3-11) We present an unusual and rather unexpected cause of acute renal failure and massive proteinuria in a patient with a history of diabetes. The case shows the complexities involved in such instances and the value of a renal biopsy in the management of kidney disease in selected individuals.