Skip navigation
MedlinePlus Trusted Health Information for You U.S. National Library of MedicineNational Institutes of Health
Contact Us FAQs Site Map About MedlinePlus
español Home Health Topics Drug Information Medical Encyclopedia Dictionary News Directories Other Resources

 

Medical Encyclopedia

Other encyclopedia topics:  A-Ag  Ah-Ap  Aq-Az  B-Bk  Bl-Bz  C-Cg  Ch-Co  Cp-Cz  D-Di  Dj-Dz  E-Ep  Eq-Ez  F  G  H-Hf  Hg-Hz  I-In  Io-Iz  J  K  L-Ln  Lo-Lz  M-Mf  Mg-Mz  N  O  P-Pl  Pm-Pz  Q  R  S-Sh  Si-Sp  Sq-Sz  T-Tn  To-Tz  U  V  W  X  Y  Z  0-9 

Minimal change disease

Printer-friendly versionEmail this page to a friend
Contents of this page:

Illustrations

Male urinary system
Male urinary system

Alternative names    Return to top

Minimal change nephrotic syndrome; Nil disease; Lipoid nephrosis; Idiopathic nephrotic syndrome of childhood

Definition    Return to top

Minimal change disease is a kidney disorder. Each kidney is made of more than a million units called nephrons. Each nephron has a tuft of blood vessels called a glomerulus, which is surrounded by a Bowman's Capsule. Together, these structures filter blood and form urine.

Minimal change disease is one cause of nephrotic syndrome. It is named "minimal change" because the nephrons appear totally normal under a light microscope. The condition is only seen using an electron microscope, which reveals changes in the Bowman's Capsule in the nephrons. Urine tests also show high protein levels.

Causes, incidence, and risk factors    Return to top

Minimal change disease is the most common cause of nephrotic syndrome in children. It is also frequently seen in adults. The cause is unknown, but the disease may be preceded by viral infection, allergic reactions, or recent immunizations.

Minimal change disease does not reduce the amount of urine produced. It rarely progresses to kidney failure.

Symptoms    Return to top

There may be symptoms of nephrotic syndrome:

Signs and tests    Return to top

A physical examination would not reveal much except swelling. Blood tests and urinalysis reveal results typical of nephrotic syndrome, including high levels of urine protein, low blood albumin levels, and high cholesterol.

A kidney biopsy and examination of the tissue with an electron microscope would show the classic changes of minimal change disease. An immunofluorescence exam of biopsied kidney tissue is negative.

Treatment    Return to top

Swelling may be treated with diuretics, blood pressure control, and ACE inhibitor medicines. You may receive instructions on how much salt to allow in your diet.

Corticosteroids can cure minimal change disease in a vast majority of children. Some patients may require maintenance on steroids to sustain the remission.

A minority of children may relapse after they stop taking steroids. If that happens, they usually respond well to a repeat course of the steroids. Adults do not respond to steroids quite as well as children, but a majority still do find steroids effective. The frequency of relapses and steroid dependence may be greater in adults.

Frequent relapsers (more than 3 relapses) may need cytotoxic therapy. In most cases, this involves a course of cyclophosphamide. Other medicines that have been used include cyclosporine and chlorambucil.

Expectations (prognosis)    Return to top

Minimal change disease usually responds well to corticosteroids, usually within the first month. Relapse may occur but the patient may benefit from prolonged treatment with corticosteroids and immunosuppressive medications.

Complications    Return to top

Calling your health care provider    Return to top

Call for an appointment with your health care provider if symptoms occur that are suggestive of minimal change disease.

If you have this disorder, call for an appointment with your health care provider if symptoms worsen or new symptoms develop, including side effects of medications used to treat the disorder.

Prevention    Return to top

There is no known prevention.

Update Date: 11/1/2003

Updated by: Irfan A. Agha, M.D., Department of Medicine, Renal Division, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.

adam.com logo

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.