Skip to main content

Health Encyclopedia

Search the Health Encyclopedia

Minimal change disease

Definition

Minimal change disease is a kidney disorder that can lead to nephrotic syndrome. Nephrotic syndrome is a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high triglyceride levels, and swelling.

Alternative Names

Minimal change nephrotic syndrome; Nil disease; Lipoid nephrosis; Idiopathic nephrotic syndrome of childhood

Causes

Each kidney is made of more than a million units called nephrons, which filter blood and produce urine.

In minimal change disease, there is damage to the glomeruli. These are the tiny blood vessels inside the nephron where blood is filtered to make urine and waste is removed. The disease gets its name because this damage is not visible under a regular microscope. It can only be seen under a very powerful microscope called an electron microscope.

Minimal change disease is the most common cause of nephrotic syndrome in children. It is also seen in adults with nephrotic syndrome, but is less common.

The cause is unknown, but the disease may occur after or be related to:

  • Allergic reactions
  • Use of NSAIDs
  • Tumors
  • Vaccinations (flu and pneumococcal, though rare)
  • Viral infections

Symptoms

There may be symptoms of nephrotic syndrome, including:

  • Foamy appearance of the urine
  • Poor appetite
  • Swelling (especially around the eyes, feet, and ankles, and in the abdomen)
  • Weight gain (from fluid retention)

Minimal change disease does not reduce the amount of urine produced. It rarely progresses to kidney failure.

Exams and Tests

The health care provider may not be able to see any signs of the disease, other than swelling. Blood and urine tests reveal signs of nephrotic syndrome, including:

  • High cholesterol
  • High levels of protein in the urine
  • Low levels of albumin in the blood

A kidney biopsy and examination of the tissue with an electron microscope can show signs of minimal change disease.

Treatment

Medicines called corticosteroids can cure minimal change disease in most children. Some children may need to stay on steroids to keep the disease from returning.

In adults, steroids are effective, but less so than in children. Adults may have more frequent relapses and become dependent on steroids.

If steroids are not effective, the provider will likely suggest other medicines.

Swelling may be treated with:

  • ACE inhibitor medicines
  • Blood pressure control
  • Diuretics (water pills)

You may also be told to reduce the amount of salt in your diet.

Outlook (Prognosis)

Children usually respond better to corticosteroids than adults. Children often respond within the first month.

A relapse can occur. The condition may improve after long-term treatment with corticosteroids and medicines that suppress the immune system (immunosuppressive medicines).

When to Contact a Medical Professional

Call your provider if:

  • You develop symptoms of minimal change disease
  • You have this disorder and your symptoms get worse
  • You develop new symptoms, including side effects from the medicines used to treat the disorder

References

Appel GB, Radhakrishnan J, D'Agati VD. Secondary glomerular disease. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 33.

Pais P, Avner ED. Nephrotic syndrome. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 527.

Review Date:12/18/2017
Reviewed By:Walead Latif, MD, nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.

Health Outcome Data

No data available for this condition/procedure.

Read More

Acute kidney failure *

Nephrotic syndrome


* Has Related Health Outcome Information

Health Encyclopedia

More Features

We Appreciate Your Feedback!
1. Did you find this information useful?
         Yes
         No
2. Would you recommend this website to family and friends?
         Yes
         No