Minimal change disease

Last reviewed: 3 May 2023
Last updated: 24 Sep 2020



History and exam

Key diagnostic factors

  • facial or generalized edema
  • age >1 year but <8 years
More key diagnostic factors

Other diagnostic factors

  • normal BP
  • absence of hematuria
  • history of recent viral illness
  • dyspnea
  • history of lymphoma or leukemia
Other diagnostic factors

Risk factors

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

Diagnostic investigations

1st investigations to order

  • urinalysis
  • 24-hour urine protein
  • urine protein/creatinine ratio
  • serum albumin level
  • serum lipid profile
  • serum complement levels
  • serum electrolyte panel
  • complete blood count
  • glomerular filtration rate (GFR)
  • serum LFTs
  • renal ultrasound
More 1st investigations to order

Investigations to consider

  • chest x-ray
  • renal biopsy
More investigations to consider

Treatment algorithm


initial presentation


infrequent relapse

frequent relapse or corticosteroid-dependent or severe corticosteroid adverse effects



Mehul P. Dixit, MD, DM (Nephrology)
Mehul P. Dixit

Professor and Chief Medical Director

Pediatric Dialysis & Renal Transplantation

Pediatric Nephrology

Department of Pediatrics

Blair E. Batson Hospital for Children

University of Mississippi Medical Center




MPD has acted as a consultant for Retrophin Pharmaceuticals.


Dr Mehul P. Dixit 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


South Africa


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



FJK declares that he has no competing interests.

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