Review Article

Minimal Change Disease: A Review

Authors: Tapasi C. Saha, MD, Harmeet Singh, MD

Abstract

Minimal change disease (MCD) is a histopathological lesion in the kidney that is most commonly associated with nephrotic syndrome. The majority of the cases are idiopathic. Pathogenesis is not well understood, although T-cell-related mechanisms are implicated. Massive proteinuria leads to hypoalbuminemia, salt retention, disorder of hemostasis, hyperlipidemia and increased susceptibility to infections. Renal biopsy remains the gold standard for diagnosis. MCD is highly responsive to corticosteroids. Other immunosuppressive agents such as cyclophosphamide, cyclosporin, azathioprine and mycophenolate mofetil have been used to treat cases which are resistant to steroids.


Key Points


* Minimal change disease presents as nephrotic syndrome.


* T-cell-related mechanisms are implicated in pathogenesis.


* Renal biopsy is the gold standard for diagnosis.


* Patients may be prone to hypercoagulable state.


* Steroids and other immunosuppressive-based regimens are used for treatment.

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