What is the typical treatment for minimal change disease?

Minimal change disease (MCD) is the most common cause of nephrotic syndrome in children and is characterized by significant proteinuria, edema, and hypoalbuminemia, often presenting after a respiratory infection or allergy. The cornerstone of treatment for MCD is corticosteroids, particularly prednisone.

High-dose prednisone is typically administered as the initial treatment for patients with minimal change disease. This approach is effective because the underlying pathophysiology of MCD involves an immune-mediated process leading to podocyte injury and increased glomerular permeability to proteins. Systemic corticosteroids work by dampening this immune response and restoring the integrity of the glomerular filtration barrier.

Patients usually respond well to high-dose prednisone, with a significant reduction in proteinuria and resolution of symptoms such as edema. The response to steroid therapy can help confirm the diagnosis of minimal change disease, as other forms of nephrotic syndrome may not respond as effectively to steroids.

While low-dose prednisone can be beneficial for maintaining remission, especially in cases of frequently relapsing nephrotic syndrome, the initial treatment of choice for active disease involves high doses to quickly address the symptoms and prevent complications associated with nephrotic syndrome.

Other options like cyclophosphamide and immunosuppressive therapy may