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Minimal change disease is a kidney disease in which there is damage to the filtering units of the kidney (glomeruli). It is the most common cause of nephrotic syndrome in children. Nephrotic syndrome is comprised of a group of symptoms including protein in the urine (proteinuria), low protein levels in the blood, high cholesterol and triglycerides, an increased risk for blood clots, and swelling. Other features of this disease include weight gain and a foamy appearance of the urine. The cause of minimal change disease is unknown, but it may occur following an allergic reaction or infection. Treatment may involve the use of steroids.
Source: GARD Last updated on 05-01-20
In individuals who are not treated, there is an increased risk for infection and blood clotting events. About 5-10% of untreated adults may have spontaneous remission (resolution) of disease within a few months.
One major indication of the long-term outcome of MCD is the initial response to corticosteroid treatment. About 80-95% of adults with MCD who receive treatment via corticosteroids experience complete remission of symptoms. About half of all adults treated for MCD have remission within four weeks, while 10-25% require longer treatment. MCD may recur or relapse in about half of all adults. This usually occurs within one year of treatment.
Despite the potential for the disease to recur, the occurrence of kidney failure and end stage renal disease is rare.
Last updated on 05-01-20
Corticosteroids are typically the first line of treatment for minimal change disease. The fluid retention and high blood pressure that often accompanies minimal change disease may be treated with the use of water pills (diuretics) in combination with a low sodium diet and blood pressure medications (such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blocker (ARB), calcium channel antagonists).
Other medications that may be used in instances of disease recurrence include those that are used to treat certain types of cancer (cyclophosphamide, chlorambucil, rituximab) and those that suppress the immune system (cyclosporine, tacrolimus, azathioprine, mycophenolate mofetil).
There is an increased risk for the formation of blood clots (thromboembolic events) and infection in individuals with minimal change disease. It is recommended that individuals with minimal change disease stay active and should a blood clot occur, they may be treated with blood thinners. Infections, such as cellulitis, peritonitis, and pneumonia are common in individuals with minimal change disease and should be treated quickly.
Last updated on 05-01-20
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