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[Diagnosis and treatment of Minimal Change Disease in adults-2023]

Philipp Gauckler1, Heinz Regele2, Kathrin Eller3

  • 1Department Innere Medizin IV (Nephrologie und Hypertensiologie), Medizinische Universität Innsbruck, Innsbruck, Österreich. philipp.gauckler@i-med.ac.at.

Wiener Klinische Wochenschrift
|September 20, 2023
PubMed

Insights

Minimal change disease, a cause of nephrotic syndrome, is diagnosed via kidney biopsy. This consensus provides guidance on managing adult patients, especially those with difficult-to-treat forms.

Area of Science:

  • Nephrology
  • Immunology
  • Pathology

Context:

  • Minimal change disease (MCD) is a primary glomerulopathy causing acute nephrotic syndrome.
  • Diagnosis relies on renal biopsy showing podocyte effacement without light microscopic lesions.
  • An autoimmune basis is suspected due to responsiveness to immunosuppression.

Purpose:

  • To establish a consensus for diagnosing and managing adult patients with Minimal Change Disease.
  • To provide evidence-based recommendations for treatment strategies.
  • To address challenges in managing steroid-dependent, resistant, or relapsing MCD.

Summary:

  • Minimal change disease presents as acute nephrotic syndrome, diagnosed by characteristic podocyte changes on electron microscopy.
  • While often responsive to glucocorticoids, some patients experience steroid-dependent, resistant, or relapsing courses.
  • The Austrian Society of Nephrology (ÖGN) developed this consensus for optimal adult patient care.

Impact:

  • Improved diagnostic accuracy and timely management of Minimal Change Disease.
  • Standardized treatment approaches for complex MCD cases, potentially reducing morbidity.
  • Enhanced understanding and clinical guidance for nephrologists managing this condition.
Keywords:
GlucocorticoidsMinimal Change DiseasePodocytopathyRituximab

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