National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Minimal change disease


Other Names:
Idiopathic minimal change nephrotic syndrome; Minimal change nephrotic syndrome; Minimal change glomerulopathy; Idiopathic minimal change nephrotic syndrome; Minimal change nephrotic syndrome; Minimal change glomerulopathy; MCNS See More
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Subtypes:
Minimal change disease is a kidney disease in which there is damage to the filtering units of the kidney (glomeruli). It is the most common cause of nephrotic syndrome in children.[1][2] Nephrotic syndrome is comprised of a group of symptoms including protein in the urine (proteinuria), low protein levels in the blood, high cholesterol and triglycerides, an increased risk for blood clots, and swelling.[3] Other features of this disease include weight gain and a foamy appearance of the urine.[2] The cause of minimal change disease is unknown, but it may occur following an allergic reaction or infection.[1] Treatment may involve the use of steroids.[1][2]
Last updated: 1/12/2018
Corticosteroids are typically the first line of treatment for minimal change disease. The fluid retention and high blood pressure that often accompanies minimal change disease may be treated with the use of water pills (diuretics) in combination with a low sodium diet and blood pressure medications (such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blocker (ARB), calcium channel antagonists).

Other medications that may be used in instances of disease recurrence include those that are used to treat certain types of cancer (cyclophosphamide, chlorambucil, rituximab) and those that suppress the immune system (cyclosporine, tacrolimus, azathioprine, mycophenolate mofetil).[4][5]

There is an increased risk for the formation of blood clots (thromboembolic events) and infection in individuals with minimal change disease. It is recommended that individuals with minimal change disease stay active and should a blood clot occur, they may be treated with blood thinners. Infections, such as cellulitis, peritonitis, and pneumonia are common in individuals with minimal change disease and should be treated quickly.[5]
Last updated: 1/12/2018
In individuals who are not treated, there is an increased risk for infection and blood clotting events. About 5-10% of untreated adults may have spontaneous remission (resolution) of disease within a few months.

One major indication of the long-term outcome of MCD is the initial response to corticosteroid treatment. About 80-95% of adults with MCD who receive treatment via corticosteroids experience complete remission of symptoms. About half of all adults treated for MCD have remission within four weeks, while 10-25% require longer treatment. MCD may recur or relapse in about half of all adults. This usually occurs within one year of treatment.[4]

Despite the potential for the disease to recur, the occurrence of kidney failure and end stage renal disease is rare.[4][5]
Last updated: 1/12/2018

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Minimal change disease. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Patient Registry

  • The Nephrotic Syndrome Rare Disease Clinical Research Network (NEPTUNE) is a team of doctors, nurses, research coordinators, and research labs throughout the U.S., working together to improve the lives of people with focal and segmental glomerulosclerosis, minimal change disease, membranous nephropathy, and nephrotic syndrome, other or unspecified caused, through research. The Nephrotic Syndrome Rare Disease Clinical Research Network (NEPTUNE) has a registry for patients who wish to be contacted about clinical research opportunities.

    For more information on the registry see: https://neptune-study.org/get-involved/

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Organizations Providing General Support

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Minimal change disease. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

  1. Meyrier A, Radhakrishnan J. Etiology, clinical features, and diagnosis of minimal change disease in adults. UpToDate. October 30 2017; https://www.uptodate.com/contents/etiology-clinical-features-and-diagnosis-of-minimal-change-disease-in-adults.
  2. National Kidney Foundation. Minimal Change Disease. https://www.kidney.org/atoz/content/minimal-change-disease. Accessed 1/12/2018.
  3. Nephrotic syndrome. MedlinePlus. 8/1/2017; https://medlineplus.gov/ency/article/000490.htm.
  4. Meyrier A. Treatment of minimal change disease in adults. UpToDate. July 5, 2016; https://www.uptodate.com/contents/treatment-of-minimal-change-disease-in-adults.
  5. Mansur A, Georgescu F, Lew S. Minimal-Change Disease. Medscape. July 30, 2017; https://emedicine.medscape.com/article/243348.