Monday, January 18, 2010

Minimal Change Disease

Minimal change disease, also called nil disease, is a renal disorder in which the glomeruli of the kidney are damaged, causing nephrotic syndrome in children. Although minimal change disease mostly affects children, it is also frequently seen in adults.

It is by far the most common cause of nephrotic syndrome (NS) in children under 10 years of age, accounting for the majority (about 90%) of these diagnoses. Among teenagers who develop NS, it is caused by minimal change disease about half the time. It can also occur in adults but accounts for less than 20% of adults diagnosed with NS. Among children less than 10 years of age, boys seem to be more likely to develop minimal change disease than girls.

Although the cause is unknown, the disease can occur after allergic reactions and viral infection. The symptoms are proteinuria (leakage of protein into the urine) and edema (water retention). When viewed with an electron microscope, it discloses diffuse loss of podocytes. Nevertheless, the appearance is normal using optical microscope.

To treat minimal change disease, prednisone is prescribed along with a blood pressure medication, typically an ACE inhibitor such as lisinopril. Some nephrologists will start out with the ACE inhibitor first in an attempt to reduce the blood pressure's force which pushes the protein through the cell wall in order to lower the proteinuria.