Minimal Change Disease

Minimal Change Disease:

  • Causes nephrotic syndrome (non-diabetic):
    • Childhood: 70%-90%
    • Adult: 10-15%
      • Clinical features:
        • Age > 45, sudden onset of symptoms, HTN (some)
        • Explosive-onset (days) of nephrotic syndrome (unlike other forms of nephrotic syndrome that progress over years)
          • Bilateral 3+ edema, 4+ proteinuria, low albumin, elevated cholesterol
          • ***Occurs shortly after URI***
          • Lack of RBCs or casts on UA, normal GFR
          • Normal BP
      • Labs:
        • Nephrotic range proteinuria (>3g/day)
        • Serum albumin < 2.2g/dL
        • Serum cholesterol > 420mg/dL
        • Acute kidney injury (some)
      • Renal biopsy:
        • Light microscopy: “nil” – nothing in light microscopy
          • Normal-appearing glomeruli
        • Immunofluorescence: No immune deposits
        • Electron microscopy: Effacement of the podocyte foot processes.

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