Diabetes mellitus is a systemic disorder that affects many organs in the body. Diabetic nephropathy occurs a number of years after the onset of the disease, and it is usually manifested by the development of the nephrotic syndrome. However, the sudden onset of massive proteinuria or the rapid deterioration of renal function in the stable diabetic patient should suggest that an additional pathologic condition is affecting the kidneys. We report three cases of diabetic nephropathy complicated by other superimposed renal diseases.
(Arch Intern Med 137:732-734, 1977)