The Nephrotic Syndrome in Children with Diabetes Mellitus of Recent Onset

Abstract

In five children a nephrotic syndrome developed within one month (three cases), 11 months, and 10 years of the onset of diabetes mellitus. The syndrome, which responded to steroid therapy, was morphologically typical of the idiopathic nephrotic syndrome of childhood. In all patients light, fluorescence and electron microscopy performed on the initial kidney-biopsy specimens demonstrated normal glomerular basement-membrane thickness and early mesangial and arteriolar changes compatible with diabetes mellitus. Although this may represent a chance association, a metabolic defect in the basement membrane common to both diabetes mellitus and the nephrotic syndrome remains a possibility.