What is the common presentation of Minimal change disease?

nephrotic syndrome

What are the main clinical features of Minimal change disease?

• nephrotic syndrome
• normotension - hypertension is rare
• highly selective proteinuria (only intermediate-sized proteins such as albumin and transferrin leak through the glomerulus)

What is the management of Minimal change disease?

• oral corticosteroids: majority of cases (80%) are steroid-responsive
• cyclophosphamide is the next step for steroid-resistant cases

What are the main causes of Minimal change disease?

• mostly idiopathic (80%)
• drugs: NSAIDs, rifampicin
• Hodgkin's lymphoma, thymoma
• infectious mononucleosis

What is the pathophysiology of Minimal change disease?

• T-cell and cytokine-mediated damage to the glomerular basement membrane → polyanion loss
• the resultant reduction of electrostatic charge → increased glomerular permeability to serum albumin

What is the prognosis of Minimal change disease?

• 1/3 have just one episode
• 1/3 have infrequent relapses
• 1/3 have frequent relapses which stop before adulthood

What is seen on renal biopsy in Minimal change disease?

• normal glomeruli on light microscopy
• electron microscopy shows fusion of podocytes and effacement of foot processes