Minimal Change Disease

Know the incidence of Minimal Change Nephrotic Syndrome in children and adults

• 75% of idiopathic nephrotic syndrome in children

• 20% in adults

Know the urinary findings, blood chemical profile, clinical presentation, and age of patients with Minimal Change Nephrotic Syndrome

• Nephrotic Syndrome (see above)

• 33% may have hypovolemia  reduced renal perfusion and GFR

• Peak incidence is in children 2 - 6

Is proteinuria selective in Minimal Change Nephrotic Syndrome?

• Yes (90% albumin), due to loss of charge barrier

• IgG/Albumin < 0.1

Know the prognosis of Minimal Change Nephrotic Syndrome

• Spontaneous remission rate is ~25-40%

• Mortality rate is ~7-12% in nephrotic children ; <>

• 90% of children respond to prednisone w/in 4 weeks

• 90% of adults w/in 8 weeks

• 50% of those that respond to steroids become frequent relapsers or steroid dependent

Know the possible pathogenesis of Minimal Change Nephrotic Syndrome

• Abnormality in T lymphocytes  lymphokine production  neutralization/destruction of glomerular polyanions  loss of charge barrier  increase in permeability

Category: Pathology Notes