Minimal Change Disease

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The next session of GlomCon’s Nephropathology Essentials will be held this Tuesday, June 12th at 11 am EDT. Dr. Helmut Rennke will be leading the session which will focus on Minimal Change Disease and FSGS (see below for session details).

Minimal change disease (MCD) is the most common cause of nephrotic syndrome in children > 1 year of age. Adult MCD is much less common but remains an important cause of nephrotic syndrome in this population. Here are some quick points to remember in adults with MCD:

  • Bimodal presentation: young children and very old adults
  • The slight male predominance (2:1) found in children disappears in the adult population
  • More common in atopic patients
  • Clinical presentation: Abrupt onset of edema, nephrotic range proteinuria, severe hypoalbuminemia and severe hyperlipidemia
  • There is a long list of secondary causes of MCD, but important ones to remember include: NSAIDs, Lithium, and Lymphoma 
  • Microscopic hematuria is seen in 10-30% of cases
  • AKI is present in 20% of cases (higher risk in older age, males, and presence of HTN)
  • Best initial treatment is corticosteroids 
    • Prednisone 1 mg/kg (maximum 80 mg) daily or alternative-day dosing of 2 mg/kg (max 120 mg)
  • Time to complete remission is much longer in adults, requiring 12-16 weeks
  • Relapse rates in adults with MCD are high
This is reviewed nicely in the following articles

MCD was also covered in this past GlomCon session. For further on both MCS and FSGS pathology, make sure to join the session on Tuesday.


GlomCon’s Nephropathology Essentials Details:
To join the meeting go to: https://glomcon.zoom.us/ and select ‘Join a Meeting’. Enter the Meeting ID into the web site (or connect directly from your Zoom app).
Meeting ID: 394-801-817
You HAVE to be logged into ZOOM to join the session. You may either create a free ZOOM account, or sign in through a Google or Facebook account (if you have one).  
Alternatively, use your institution’s ‘Polycom’ system, enter IP address:
US West: 162.255.37.11
US East: 162.255.36.11
Europe: 213.19.144.110
Then, enter the Meeting ID: 394-801-817

Posted by: Pravir Baxi, Rush University Medical Center

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