Minimal Change Disease

Minimal Change Disease (MCD) is a disorder in which there is damage to the glomeruli. A glomerulus (plural – glomeruli) is a cluster of capillaries in the kidney which is responsible for filtering waste products from the blood. Minimal Change Disease is called so because the damage cannot be seen under a light microscope. It can only be seen under an electron microscope. It is the most common cause of nephrotic syndrome in children. It is also seen in adults but is less common.

Causes:

MCD can be primary/idiopathic (which means that the exact cause is unknown) or secondary (caused by another disease or drug). It is usually primary in children and secondary in adults.

Secondary causes of MCD can be:

  • Allergic reactions
  • Drugs – Lithium, painkillers (NSAIDs), some antibiotics
  • Tumors – Leukemia, Lymphoma
  • Viral infections, Syphilis, HIV, Hepatitis

Signs & Symptoms:

  • Foamy urine – due to proteinuria (protein leaking into the urine)
  • Swelling all over the body, like around the ankles and eyes – due to fluid buildup in the body. This is known as edema.
  • Weight gain due to fluid buildup
  • Nephrotic Syndrome: characterized by a set of symptoms that occur together and affects the kidneys. These include edema, proteinuria, loss of protein in blood (hypoalbuminemia), high levels of fats/lipids in the blood (hyperlipidemia) and increased tendency to form blood clots (hypercoagulability).

Diagnosis:

  • Urine test: to detect protein and blood in the urine
  • Blood test: to detect protein, cholesterol and waste products in the blood
  • Glomerular filtration rate (GFR): to determine how well your kidneys are filtering wastes from your body
  • Kidney biopsy: shows normal appearing glomeruli on the light microscope

Treatment:

Treatment is initially started with a type of drug called corticosteroids, often called steroids. It is generally effective within weeks. A complete remission may occur, but it can recur later in life. Those with recurrent MCD that does not resolve with steroids may require other forms of chemotherapy.

For the symptoms of swelling (edema), you may also receive:

  • ACE Inhibitor (angiotensin converting enzyme inhibitors) or ARBs (angiotensin II receptor blockers)
  • Diuretics (water pills)
  • Low salt (sodium) diet

Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.