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Transition from minimal change disease to focal segmental glomerulosclerosis related to occupational exposure: A case

Long Tang1, Zhen Cai1, Su-Xia Wang2

  • 1Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.

World Journal of Clinical Cases
|August 18, 2022
PubMed
Abstract

Insights

Minimal change disease (MCD) can progress to focal segmental glomerulosclerosis (FSGS), suggesting they may be stages of the same kidney disease. Occupational metal exposure may contribute to this progression and end-stage kidney disease (ESKD).

Area of Science:

  • Nephrology
  • Toxicology
  • Pathology

Background:

  • Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are distinct nephrotic syndromes (NS).
  • The relationship between MCD and FSGS is not fully understood.
  • This study explores the potential progression from MCD to FSGS.

Observation:

  • A 42-year-old male with a history of MCD developed FSGS and end-stage kidney disease (ESKD).
  • The patient was an electric welder with high blood levels of cadmium and lead.
  • Occupational metal exposure is suspected as a cause of disease progression.

Findings:

  • The patient's kidney biopsy transitioned from MCD to FSGS.
  • Metal nephrotoxicity is implicated in the progression of kidney disease.
  • Quitting the metal-exposed occupation and treatment led to partial kidney function recovery.

Implications:

  • MCD and FSGS might represent different stages of a single disease process.
  • Occupational exposure to metals like cadmium and lead can exacerbate kidney conditions.
  • Understanding disease progression is crucial for managing nephrotic syndromes.
Keywords:
CadmiumCase reportFocal segmental glomerulosclerosisLeadMinimal change diseaseOccupational exposure

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