Minimal change disease
Description
- Nephrotic syndrome with a normal glomerulus on light microscopy
- The only abnormality is diffuse podocyte foot process effacement on EM
- Abrupt onset, highly steroid-responsive, does not scar
- *MCD and FSGS are probably a spectrum - a 'MCD' that is steroid-resistant is often unsampled FSGS*
The characteristic clinical signature
- Sudden, gross oedema over days - not the insidious course of membranous
- Very heavy proteinuria (often >10 g/day) with preserved eGFR
- Highly selective proteinuria (albumin, not larger proteins)
- Normal blood pressure, normal complement, bland sediment
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