The points of this examination are To evaluate the reaction and adequacy of melanocortin receptor agonist (ACTH) as a treatment for patients with stubborn diabetic nephropathy . This examination was performed on 50 diabetic patients who went to inner medication division at banha college emergency clinic. Patients with diabetic nephropathy gave proteinuria more than 1gm/24hour pee assortment and who are not reacting to against proteinuric measures for at any rate one month of treatment rewarded with engineered ACTH permitting a 6 months development. Result. The essential endpoint was the level of patients accomplishing a total reduction (