Highlights & Basics
- The most common form of nephrotic syndrome in children, characterized by minimal histologic changes in the kidney; 90% of cases are idiopathic.
- Children typically present with peripheral edema, although some are asymptomatic. Diagnosis is usually made on clinical grounds.
- Corticosteroid therapy is the mainstay of treatment. Long-term corticosteroid therapy has significant adverse effects; therefore, if needed, corticosteroid-sparing therapies can be added.
- Renal biopsy is usually reserved for those patients who do not respond to corticosteroid therapy or have frequent relapses, or for the diagnosis of patients <1 year old.
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Definition
Epidemiology
Etiology
Pathophysiology
Images
Podocyte effacement on electron microscopy
Normal glomerular basement membrane on electron microscopy
Diagnostic algorithm for MCD nephrotic syndrome
Facial edema demonstrated in a child presenting in relapse
Edema of the legs
Pleural effusion
Acute glomerulonephritis: wet lungs
Resolution of facial edema a few months later following a successful course of treatment
Treatment algorithm for MCD nephrotic syndrome (NS). FSGS: focal segmental glomerulosclerosis; IV: intravenous
Citations
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Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet. 2003 Aug 23;362(9384):629-39.[Abstract]
Shigidi MM. The treatment of relapse in adults with minimal change nephrotic syndrome: myths and facts. Saudi J Kidney Dis Transpl. 2011;22:10-17.[Abstract]
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