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The aims of this study are to To assess the response and efficacy of melanocortin receptor agonist (ACTH) as a treatment for patients with refractory diabetic nephropathy . This study was performed on 50 diabetic patients who attended internal medicine department at banha university hospital. Patients with diabetic nephropathy presented with proteinuria more than 1gm/24hour urine collection and who are not responding to anti proteinuric measures for at least one month of treatment treated with synthetic ACTH allowing a 6 months follow-up. Outcome. The primary endpoint was the percentage of patients achieving a complete remission (<300mg/24 hours) within 6months. Exploratory endpoints included the percentage of partial (50% reduction) remissions, changes in Cr, eGFR. Results. After 6months of ACTH therapy, 29 patients (58%) had achieved a complete remission and nine patients had achieved partial remission (18%).Conclusion. ACTH gel stabilizes renal function and reduces urinary protein.

Melanocortin Receptor Agonist (Corticotrophin) in Treatment of Refractory Diabetic Nephropathy