Clinical characteristics and outcomes of adults with minimal change disease: A retrospective, cross-sectional study

Minimal change disease (MCD) is a common cause of nephrotic syndrome in adults, with limited evidence available on its treatment and prognosis. In this study, we retrospectively included the clinical characteristics and treatment results of adult MCD patients in our center and explored and analyzed potential risk factors for relapse in MCD patients. We included 51 adult MCD patients with a median age of 29 years, and 30 were men. Among them, 16 patients (31.37%) had acute kidney injury (AKI) at presentation. The average urinary protein excretion was 6.39 ± 5.54 g. Notably, 29 (59%) patients had hematuria; 16 (31.37%) patients developed AKI; and 25 patients (49.02%) experienced at least 1 relapse. 13 patients (25.49%) experienced 2 relapses, and 9 patients (17.65%) experienced 3 or more relapses during the observation period. Compared with non-relapse patients, relapse patients were younger (mean age, 18 years (18 - 32 years)), and fewer patients (n = 8, 32%) had positive urinary red blood cells. The time from treatment to remission and baseline albumin, renal function, urine protein quantification, and other laboratory indicators did not significantly differ between the two groups (all, p > 0.05). Single and multivariate logistic regression analysis revealed age of onset, drug-related adverse effects during treatment, and AKI as the risk factors for relapse. This study identified young age at onset, treatment-related adverse effects, and AKI as independent risk factors for relapse in adult-onset MCD patients. Rituximab may be an effective treatment for relapsed MCD patients.