What is minimal-change disease (MCD)?

Updated: Jan 05, 2021
  • Author: Abeera Mansur, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Minimal-change disease (MCD), also known as lipoid nephrosis or nil disease, arises from a histopathologic lesion in the glomerulus and is characterized by intense proteinuria leading to edema and intravascular volume depletion. [1] It is the most common single form of nephrotic syndrome in children, but it can also occur in adults. [2]

On laboratory testing, profound proteinuria and oval fat bodies may be observed. In children, the critical level for diagnosis is proteinuria of more than 40 mg/h/m2. In adults, the threshold is more than 3.5 g/d/1.73 m2. (See Workup.)

Treatment includes measures to clear proteinuria, reverse hypovolemia, and reduce edema. Corticosteroids are the treatment of choice, leading to complete remission of proteinuria in most cases. Recurrence is common, however. Options for steroid-sparing therapy and steroid-resistant cases include cyclophosphamide, chlorambucil, mycophenolate, rituximab, and tacrolimus. See Treatment and Medication.

For patient education information, see the Nephrotic Syndrome Overview.


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