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Minimal change disease

Last reviewed: 3 Apr 2025
Last updated: 18 Mar 2025

Summary

Definition

History and exam

Key diagnostic factors

  • facial or generalized edema
  • age >1 year but <8 years
Full details

Other diagnostic factors

  • normal BP
  • absence of hematuria
  • history of recent viral illness
  • dyspnea
  • history of lymphoma or leukemia
Full details

Risk factors

  • age >1 year but <8 years
  • Hodgkin lymphoma
  • leukemia
  • recent viral illness
  • hepatitis B or C infection
  • low birth weight (LBW)
Full details

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
Full details

Tests to consider

  • CXR
  • kidney biopsy
  • genetic testing
Full details

Treatment algorithm

ACUTE

initial presentation

ONGOING

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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  • Guidelines

    • IPNA clinical practice recommendations for the diagnosis and management of children with steroid‑sensitive nephrotic syndrome
    • KDIGO clinical practice guideline for glomerular diseases
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  • Calculators

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    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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