Minimal Change Disease - symptoms and treatment
A disorder of kidney function in which the structure of the KIDNEYS, notably the nephrons, appears normal with regular (light) microscope examination though slightly abnormal with electron microscope examination. Minimal change disease is primarily a condition of childhood (usually in children under age six) and seldom occurs in adults. Researchers believe the condition is one of immune dysfunction in which T-cell lymphocytes cause molecular damage to the delicate walls of the glomeruli. The damage allows ALBUMIN (protein) to leak from the BLOOD into the URINE (ALBUMINURIA).
Symptoms of Minimal Change Disease and Diagnostic Path
The symptoms of minimal change disease are often vague and include
- edema, often of the face
- fatigue
- MUSCLE-wasting
- impaired growth
- unexplained weight gain
The diagnostic path begins with urinalysis, which typically shows albuminuria (albumin excretion). Other laboratory tests are often normal. There is a high correlation between minimal change disease and NEPHROTIC SYNDROME, a constellation of symptoms that indicate kidney dysfunction. The urologist may recommend a trial of treatment before conducting further, more invasive diagnostic procedures.
Minimal Change Disease - Treatment Options and Outlook
Treatment for minimal change disease is IMMUNOSUPPRESSIVE THERAPY with CORTICOSTEROID MEDICATIONS such as prednisone. Most children improve remarkably within two weeks, and nearly all within six to eight weeks. The nephrologist may make dietary recommendations to maintain appropriate protein, sodium, and fluid intake. Minimal change disease fully resolves, without residual damage to the kidneys, with treatment in most children. About 10 percent of children experience periodic RECURRENCE of symptoms through ADOLESCENCE and sometimes into adulthood. Children taking corticosteroid medications have a somewhat increased risk for INFECTION during the course of therapy.
Risk Factors and Preventive Measures
Because researchers do not know what causes minimal change disease, there are no measures to prevent its occurrence. Prompt treatment minimizes the risk for permanent damage to the kidneys.
See also GLOMERULONEPHRITIS; GLOMERULOSCLEROSIS; NEPHRON.
