Summary about Disease
Minimal Change Disease (MCD) is a kidney disorder that causes nephrotic syndrome, characterized by excessive protein in the urine (proteinuria), low levels of protein in the blood (hypoalbuminemia), swelling (edema), and high cholesterol levels. It's called "minimal change" because the kidney tissue appears nearly normal under a regular microscope; changes are only visible with more specialized tests like electron microscopy. It's a leading cause of nephrotic syndrome in children.
Symptoms
Swelling (edema), particularly around the eyes, ankles, and feet
Weight gain due to fluid retention
Foamy urine (due to excess protein)
Fatigue
Loss of appetite
Abdominal pain (sometimes)
High cholesterol
Increased susceptibility to infections
Causes
The exact cause of MCD is usually unknown (idiopathic). However, it's believed to be related to immune system dysfunction. Possible triggers include:
Viral infections
Allergies (e.g., to insect bites, pollen)
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Certain cancers (rarely)
Immune reactions
Medicine Used
Corticosteroids (e.g., Prednisone): These are the primary treatment and are highly effective in inducing remission (stopping protein loss).
Immunosuppressants (e.g., Cyclophosphamide, Cyclosporine, Tacrolimus, Mycophenolate mofetil): Used for patients who relapse frequently or don't respond to steroids, or have unacceptable side effects from steroids.
Albumin infusions: To temporarily increase protein levels in the blood and reduce swelling (used in severe cases).
Diuretics: To reduce fluid retention (edema).
ACE inhibitors or ARBs: To reduce protein leakage and protect the kidneys.
Statins: To lower high cholesterol levels.
Antibiotics: To treat or prevent infections.
Is Communicable
No, minimal change disease is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
Follow doctor's instructions: Adhere strictly to prescribed medications and dosages.
Dietary modifications: Low-sodium diet to reduce fluid retention. Adequate protein intake (as recommended by a doctor or dietitian).
Monitor fluid intake: Track fluid intake and output.
Prevent infections: Practice good hygiene (handwashing), avoid contact with sick people, and get recommended vaccinations (after consulting with a physician).
Regular checkups: Attend all scheduled appointments with your doctor to monitor kidney function, medication side effects, and overall health.
How long does an outbreak last?
MCD doesn't have "outbreaks" in the traditional sense of an infectious disease. The initial episode can last for weeks to months if untreated. With treatment, the disease can go into remission. Some individuals may have relapses (recurrence of symptoms) even after successful treatment, requiring further management.
How is it diagnosed?
Urine test: To detect protein in the urine (proteinuria).
Blood test: To measure protein levels in the blood (albumin), cholesterol levels, and kidney function.
Kidney biopsy: A small sample of kidney tissue is examined under a microscope to confirm the diagnosis and rule out other kidney diseases. This is especially important in adults.
Timeline of Symptoms
The timeline can vary, but generally follows this pattern:
Initial phase: Often begins with subtle swelling, fatigue, and foamy urine. These symptoms gradually worsen over days or weeks.
Peak: Swelling becomes more pronounced, especially around the eyes and ankles. Weight gain, loss of appetite, and abdominal pain may develop.
Diagnosis and treatment: Once diagnosed, treatment (usually with corticosteroids) is initiated.
Remission: With successful treatment, symptoms gradually improve. Proteinuria decreases, edema resolves, and energy levels return to normal. This can take several weeks.
Relapse (potential): Some individuals may experience a relapse months or years later, requiring repeat treatment.
Important Considerations
Relapses are common, especially in children: Monitor for early signs of relapse (e.g., increasing proteinuria, swelling).
Long-term steroid use can have side effects: Discuss potential side effects with your doctor and monitor for them.
Regular monitoring is essential: Kidney function, blood pressure, and medication side effects should be monitored regularly.
Psychological support: Chronic illness can be stressful; consider seeking support from a therapist or counselor.
Individualized treatment: Treatment plans should be tailored to the individual's specific needs and response to medication.
Consider seeing a nephrologist: A nephrologist is a kidney specialist who can provide expert care for MCD.