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Minimal Change Disease (MCD)
Minimal Change Disease (MCD) is a disorder affecting the filtering units of the kidney (glomeruli) that can lead to symptoms associated with Nephrotic Syndrome. It is one of the most common causes of Nephrotic Syndrome in children worldwide and can also be diagnosed in adults.
Who Gets MCD
Children of all ages and even adults can get MCD, but it mostly affects young children under the age of 5. MCD is the most common cause of Nephrotic Syndrome in children, associated with 80 to 90% of cases. It makes up only 10 to 15% of Nephrotic Syndrome cases in adults. Males are twice as likely to develop MCD as females.
Signs and Symptoms
Almost 85% of children with Nephrotic Syndrome symptoms have MCD, so the term “Nephrotic Syndrome” is often used interchangeably with MCD. Because MCD does not cause permanent damage to the filters of the kidneys, the prognosis is generally good.
Some symptoms of NS include:
- Swelling in parts of the body, most noticeable around the eyes, hands, feet, and abdomen (edema)
- Weight gain due to extra fluid building up in the body
- High blood pressure (hypertension)
- High fat levels in the blood (high cholesterol)
- Protein in the urine, which can be foamy (proteinuria)
- Low levels of protein in the blood (hypoalbuminemia)
- High levels of creatinine in the blood due to your kidneys not filtering properly
Diagnosing MCD
The only way to definitively diagnose Minimal Change Disease is through a kidney biopsy. A diagnosis of MCD is given when a kidney biopsy reveals little or no change to the glomeruli or the surrounding kidney tissue, and no scarring is seen within the kidney. However, most children do not receive biopsies early in their diagnosis. Since most children with Nephrotic Syndrome symptoms have MCD, MCD is a presumed diagnosis during the typical first course of treatment with corticosteroids.
Other diagnostic tools may include:
- Urinalysis: determines the amount of protein in the urine
- Blood work: determines levels of creatinine, albumin, cholesterol, and many other factors examined to rule out other causes
- Glomerular filtration rate (GFR): Your GFR estimates your kidney function by calculating blood creatinine levels with urine protein levels. Click here for a GFR calculator.
- Ultrasound: sometimes performed to get a closer look at the kidneys
Your Treatment Options
There are currently no FDA-approved medicines to treat MCD. The standard first-line (initially prescribed) treatment for MCD is prednisone, a corticosteroid aimed at decreasing proteinuria.
The short-term goal of treatment is to stop protein spillage completely (known as remission) or lower the amount of protein lost in the urine as much as possible. The less protein lost in the urine, the better the patient will do. The long-term goals of treatment include preventing relapses of protein in the urine and preventing the deterioration of kidney function.
Clinical trials are another treatment option.
Your doctor helps you find the right study for you. These trials test more targeted treatments with potentially lower risks of side effects.
Some clinical trials enroll patients, based on their genetic testing results, to test the effectiveness of precision-based therapies targeted to specific genetic changes. These clinical trials are absolutely essential in making new treatments possible, and they need patient involvement to succeed.
Tips For Living With MCD
Patients with MCD benefit from supportive measures including:
Exercise
Regular, moderate activity helps manage your blood pressure and weight and improves your overall well-being.
Prescription Regimen
Follow your doctor’s instructions and take your medicines as prescribed.
Regular Check-Ups
See your doctor as scheduled to monitor your kidney function and quickly address any changes.
Your Nephrologist May Also Recommend
1
Diuretics
Diuretics are important as they help manage fluid retention and edema, which are common complications of kidney dysfunction.
2
Anticoagulants
Anticoagulants are essential for rare kidney disease patients to prevent the formation of blood clots.
3
Medications
Blood Pressure medications to lower high blood pressure. Statins to lower the cholesterol level. Other medications to suppress your immune system.
4
Vitamins
Vitamins play a crucial role in supporting overall health and mitigating potential complications.
