Establishing the Cause of Nephrotic Syndrome in an Unlikely Scenario – A Case Report

Abstract: Chronic hyperglycemia in the context of type 2 diabetes predisposes patients to developing diabetic chronic kidney disease. The following clinical case covers a 55-year old patient with a longstanding history of type 2 diabetes and essential hypertension admitted for typical symptoms of uncontrolled diabetes to the Diabetes Department of "Pius Brinzeu" Emergency Hospital. Clinical evaluation and laboratory results pointed to the diagnosis of nephrotic syndrome, however, did not present at first a clear cause for such high levels of proteinuria. This report follows the meticulous logic needed in order to establish the cause of nephrotic syndrome, all the way to a justifiable renal biopsy. Once diabetic nephropathy was established, adding treatment with an SGLT2i was considered a valid treatment option due to its antiproteinuric effects.