Summary
Definition
History and exam
Key diagnostic factors
- facial or generalized edema
- age >1 year but <8 years
Other diagnostic factors
- normal BP
- absence of hematuria
- history of recent viral illness
- dyspnea
- history of lymphoma or leukemia
Risk factors
- age >1 year but <8 years
- Hodgkin lymphoma
- leukemia
- recent viral illness
- hepatitis B or C infection
- low birth weight (LBW)
Diagnostic tests
1st tests to order
- urinalysis
- 24-hour urine protein
- urine protein/creatinine ratio
- serum albumin level
- serum lipid profile
- serum complement levels
- serum electrolyte panel
- CBC
- GFR
- serum LFTs
- kidney ultrasound
Tests to consider
- CXR
- kidney biopsy
- genetic testing
Treatment algorithm
initial presentation
infrequent relapse
frequent relapse
corticosteroid-dependent
Contributors
Authors
Kiran K. Upadhyay, MD
Associate Professor of Pediatrics and Pediatric Nephrology
Division of Pediatric Nephrology
Department of Pediatrics in the College of Medicine
University of Florida Health
Gainesville
FL
Disclosures
KU declares that he has no competing interests.
Acknowledgements
Dr Kiran Upadhyay would like to gratefully acknowledge Dr Robert Mathias, a previous contributor to this topic. RM declares that he has no competing interests.
Peer reviewers
Rajendra Bhimma, MD
Associate Professor of Paediatrics and Paediatric Nephrologist
Department of Maternal and Child Health
Nelson R. Mandela School of Medicine
University of KwaZulu-Natal
Durban
South Africa
Disclosures
RB is an author of a reference cited in the monograph.
Frederick J. Kaskel, MD
Professor of Pediatrics
Vice Chairman for Affiliate & Network Affairs
Chief, Section on Nephrology
Division of Pediatric Nephrology
Children's Hospital at Montefiore of Albert Einstein College of Medicine
New York
NY
Disclosures
FJK declares that he has no competing interests.
References
Key articles
Vivarelli M, Massella L, Ruggiero B, et al. Minimal change disease. Clin J Am Soc Nephrol. 2017 Feb 7;12(2):332-45.Full text Abstract
Trautmann A, Boyer O, Hodson E, et al. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome. Pediatr Nephrol. 2023 Mar;38(3):877-919.Full text Abstract
Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021 Oct;100(4s):S1-276.Full text
Hogan J, Radhakrishnan J. The treatment of minimal change disease in adults. J Am Soc Nephrol. 2013 Apr;24(5):702-11. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Acute glomerulonephritis
- Focal segmental glomerulosclerosis
- Congestive heart failure
More DifferentialsGuidelines
- IPNA clinical practice recommendations for the diagnosis and management of children with steroid‑sensitive nephrotic syndrome
- KDIGO clinical practice guideline for glomerular diseases
More GuidelinesCalculators
Glomerular Filtration Rate Estimate by the IDMS-Traceable MDRD Study Equation
Glomerular filtration rate estimation (eGFR) by CKiD U25 equations with creatinine and/or cystatin C in children and adults ≤25 years old
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