Advanced Diabetic Nephropathy with Nephrotic Range Proteinuria: A Pilot Study of the Long-Term Efficacy of Subcutaneous ACTH Gel on Proteinuria, Progression of CKD, and Urinary Levels of VEGF and MCP-1
Figure 2
(a) 24-hour urinary protein (grams/24 hrs) is shown for each patient randomized to receive 16 units of ACTH gel SQ daily. Mean proteinuria decreased significantly after six months of therapy. Proteinuria tended to fall for 6 months after stopping ACTH therapy but did not reach statistical significance. (b) 24-hour urinary protein (grams/24 hrs) is shown for each patient randomized to receive 32 units of ACTH gel SQ daily. Mean proteinuria did not decrease after six months of therapy. Proteinuria tended to increase during the six months after stopping ACTH therapy but did not reach statistical significance. Two patients, including one with a late response, achieved a sustained partial remission.
