Minimal Change Disease (MCD)
What is Minimal Change Disease?
Minimal Change Disease (MCD) is a type of kidney disease in which protein is lost in the urine. It is one of the most common cause Nephrotic Syndrome in Children worldwide and can also be diagnosed in adults. Normally, the kidneys clean or filter the blood, discarding natural waste products from the body into the urine and returning vital elements such as proteins and red blood cells back into the blood stream. When the kidney filters (glomeruli) are damaged, however, protein sometimes “slips through” the filters and escape into the urine. This is called proteinuria. Because MCD is so common; almost 85% of children with Nephrotic Syndrome symptoms have MCD, 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.
How is Minimal Change Disease Diagnosed
The only way to definitively diagnose Minimal Change disease is through a kidney biopsy. The 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, it is often assumed that a child has Minimal Change Disease if they respond well to initial treatments.
Other diagnostic tools include:
Urinalysis: determine the amount of protein in the urine
Blood Work: determine levels of Creatinine, albumin, cholesterol, and many other factors examined to rule out other causes
Glomerular Filtration Rate (GFR): http://www.nkdep.nih.gov/resources/ExplainingGFR.htm is an estimator of kidney function by calculating blood creatinine levels with urine protein levels
Renal Ultrasound or CT Scan is sometimes performed to get a closer look at the Kidney’s
What Causes MCD?
MCD is “idiopathic” which means it arises without a known cause, so researchers are actively trying to learn more.
What Are The Symptoms of MCD?
Proteinuria – Large amounts of protein “spilling” into the urine
Edema – Swelling in parts of the body, most noticeable around the eyes, hands and feet, and abdomen.
Low Blood Albumin Levels
High Cholesterol in some cases
High Blood Pressure in some cases
Who Gets MCD?
Children of all ages and even adults can get MCD, but it mostly affects young children under the age of 5. Boys are twice as likely to have it as girls.
How is MCD Treated?
Usually a steroid called prednisone or prednisolone is given to control proteinuria. Most patients will respond to treatment after several weeks. For as many as 70% of patients, the disease will come back or relapse. This requires more prednisone or other medications that suppress the immune system. If the disease does not recur for three years once off all medication, there is a good chance that it will not return.
Click here for a full list of treatments options.
Your nephrologist may also recommend:
- Diuretics and low salt diet help to control edema
- A medication that blocks a hormone system called the renin angiotensin system (ACE inhibitor or ARB) to control blood pressure or lower urine protein
- Anticoagulants to prevent blood clots
- Statins to control cholesterol
- Maintaining a healthy diet: Correct amounts of protein and fluid intake according to your nephrologist’s recommendations
- Not smoking
Learn more here: Minimal Change Disease Fact Sheet