Minimal change nephropathies, also known as minimal change disease (MCD), refer to a group of kidney disorders characterized by minimal structural changes observed under a microscope. It is the most common cause of nephrotic syndrome – a condition characterized by a combination of symptoms including excessive protein loss in urine, low levels of protein in the blood, high cholesterol levels, and swelling (edema).
In minimal change nephropathies, the glomeruli – the tiny filters within the kidneys responsible for filtering waste products and excess fluids from blood – appear normal under a light microscope. Hence, the name "minimal change" is derived from the lack of observable changes in the glomeruli. However, electron microscopy may reveal subtle abnormalities in the glomerular podocytes, specialized cells responsible for maintaining the filtration barrier.
The exact cause of minimal change nephropathies is not yet fully understood, but it is believed to involve an immune system dysfunction. It is more common in children, especially boys, and rare in adults. Affected individuals may present with symptoms like generalized edema, weight gain, foamy urine due to excess protein, and fatigue. Blood tests may show low levels of albumin and increased cholesterol. Diagnosis is made by kidney biopsy, which confirms the minimal changes observed under a microscope.
Treatment typically involves the use of immunosuppressive medications, particularly corticosteroids, which are effective in reducing proteinuria and helping the kidneys regain normal function. Most cases of minimal change nephropathies respond well to treatment, and the prognosis is generally favorable. However, relapses can occur, and long-term monitoring is important to prevent complications and maintain kidney health.
