Minimal-change glomerulopathy of adulthood

We describe 40 adults with idiopathic minimal-change glomerulopathy. They consisted of 27 females and 13 males, mean age 40.7 +/- (SD) 19.8 years (range 15-78 years). Twenty patients were less than 40 years of age at presentation. They presented with significantly (p less than 0.05) lower serum creatinine (0.9 +/- 0.2 vs. 1.3 +/- 0.5 mg/dl) and serum albumin (1.9 +/- 0.8 vs. 2.4 +/- 0.7 g/dl) levels than patients greater than 40 years. Only 7 patients (18%) presented with a decrease in renal function (serum creatinine greater than 1.3 mg/dl). All patients had nephrotic-range proteinuria at the time of presentation or biopsy. There was no significant difference in presenting proteinuria (8.7 +/- 5.7 g/24 h) or length of follow-up (mean 63.5, range 4-176 months) between the two age groups. Microscopic hematuria and hypertension were each present in 21% of the patients. Thirty-four patients received therapy with prednisone. A complete remission was obtained in 91% of the patients treated with prednisone. The response occurred within 16 weeks in 77% of the patients. The response to prednisone therapy was similar for patients less than 40 years when compared to those greater than 40 years, with a complete remission being obtained in 88 and 94%, respectively. The rate of response, however, differed significantly with 73% of patients less than 40 years versus 32% of patients greater than 40 years achieving a complete remission by 8 weeks. Twenty patients initially responding to prednisone therapy (64.5%) relapsed. A relapse occurred within 3 months of attaining a complete remission in 70% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)