Objective: An association between high homocysteine levels and PROTEINURIA in diabetic nephropathy has been shown. On the other hand, supplementation with folic acid lowers homocysteine concentration. We have studied the effects of folic acid supplementation on PROTEINURIA in type 2 diabetic patients with overt PROTEINURIA.Materials and Methods: Forty five (29 men and 16 women) type 2 diabetic patients with overt PROTEINURIA were randomized into 2 groups. One group was treated with folic acid for 6 months (22 patients), and the other was not (control group, 23 patients).Twenty-four hours PROTEINURIA, creatinine clearance, and serum homocysteine were measured at baseline and 6 months of treatment.Results: In the treatment group, baseline PROTEINURIA was 2927 ± 2858 mg/day, and after 6 months of folic acid treatment, there was a significant decrease in PROTEINURIA to 2049 ± 1641 mg/day (P< 0.05). For the control group, there was no change of PROTEINURIA after 6 months of follow-up (P=0.9). Serum homocysteine levels were significantly decreased in subjects treated with folic acid, from 19.2 ± 9.46 μmol/L to 16 ± 5.6 mmol/L; P<0.05). There were no significant differences in creatinine clearance at the end of the study comparing the two groups.Conclusion: Supplementation with folic acid decreases PROTEINURIA in type 2 diabetic patients with overt PROTEINURIA and that this action may be mediated through reduced concentrations of serum homocysteine. However, for evaluation of the effect of folic acid on renal function, further studies with longer follow-up are needed.

Introduction: Adult-onset stills disease (AOSD) is a systemic inflammatory disorder, characterized by spiking fever, skin rash, and arthritis. However, the renal involvement is a rare manifestation of the disease. Here we report a case of a 23-year old female diagnosed with AOSD with kidney disease presentation: Case Report: We describe here a 23-year old female with history of intermittent polyarthritis, fever and flu like symptoms, since 4 years ago. She was treated with Prednisolone and NSAIDs, however, she did not fully respond to medications. Since two year ago, she was found to have several episodes of disease flare up with multisystemic manifestations, including high spiking fever, arthralgias, lymphadenopathy, striking hyperferritinemia, and nephrotic range PROTEINURIA with a normal serum BUN and creatinine concentration levels.Renal biopsy was associated with the minimal histological changes. Laboratory tests for other diseases were negative. By excluding other diseases, diagnosis of AOSD was suggested. Azathioprine and steroid were started for her and NSAIDs was discontinued. However, the PROTEINURIA was still existed after several months of therapy. By changing the medication to Cyclosporine, low dose steroid, and NSAIDs, PROTEINURIA was decreased toward normal ranges.Conclusions: Clinicians should be aware that PROTEINURIA can be a manifestation of still’s disease.In these patients, urinalysis and renal function should be routinely monitored.

Transient PROTEINURIA in children can be idiopathic or secondary to exercise or fever. Exercise related PROTEINURIA usually is derived from low renal blood flow to the kidneys. It usually is defined as urinary protein excretion higher than 100-150 mg/m2/day and ends 24 hours after exercise. The intensity of exercise has a main role in the amount of protein excreting in the urine. It usually is transient. However, further assessment is needed to exclude systemic diseases if PROTEINURIA is present besides hematuria, if it does not disappear after 48 hours, or if more than 1 gram of protein is excreted from the urine in a day.

PROTEINURIA is defined as an increased abnormal urinary excretion of proteins. In normal conditions, few proteins are lost through the urine. PROTEINURIA is a problem and dilemma in pediatric practice. Non-nephrotic PROTEINURIA is described and its follow-up is discussed in the following.