Since the original description of diabetic intercapillary glomerulosclerosis by Kimmelstiel and Wilson4 in 1936, numerous reports have confirmed its existence as aspecific clinical and pathologic entity. Although the fully established syndrome is well known to the trained clinician, one must be constantly on the alert for variants in the clinical picture. The presence of doubly refractile lipoid elements in the urinarysediment is an important aid in the diagnosis, provided it is properly related to the clinical data.11 Study of the serum proteins may furnish additional laboratory evidence.

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