Minimal change disease (MCD) is a type of kidney disease that affects the glomeruli, which are the tiny filtering units inside the kidney where blood is cleaned of wastes and toxins. Learn more about it here, including the causes, symptoms, and treatment options.* 

What is MCD?

With MCD, the glomeruli are attacked and damaged inside the kidneys. The damage is not observable under a regular microscope. It can only be seen with a powerful electron microscope, which is how MCD received its name. 

What are the causes?

The causes are typically different between children and adults. For children, the disease is usually primary or idiopathic, which means the cause is unknown. For adults, it is usually secondary or caused by another disease or drugs. Some secondary causes for MCD include: 

• Allergic reactions
• Use of certain over-the-counter pain relievers called non-steroidal anti-inflammatory drugs (NSAIDs) that include aspirin, ibuprofen/Tylenol, naproxen/Aleve, and others
• Tumors
• Viral infections

What are the signs and symptoms?

Nephrotic syndrome refers to a set of symptoms that happen from damaged kidneys and will also be seen in MCD. These signs and symptoms are: 

• Proteinuria (protein in the urine), which may appear as foamy urine
• Swelling in the body, especially around the ankles and eyes, due to fluid buildup known as edema
• Weight gain from fluid buildup
• High levels of fat/ lipids in your blood, also known as high cholesterol 

How is it diagnosed? 

Once you show signs and symptoms of MCD, your healthcare provider may run a series of tests to find the cause and give a diagnosis. Some tests that may be done are:

• Urine analysis, to test for protein and blood in your urine
• Blood test, to check the levels of protein, cholesterol, and wastes in your blood
• Kidney biopsy where a tiny piece of your kidney is removed and analyzed under a microscope 

All of these tests help measure how well your kidneys are working.

What is MCD treatment?

MCD is typically easier to treat than other glomerular diseases. For both children and adults, a standard treatment option is a corticosteroid. This usually treats the symptoms of the nephrotic syndrome within a few weeks, though children may respond to it faster than some adults. Even when symptoms improve, it is important to stick to the treatment plan prescribed by your doctor and not abruptly stop taking steroids. 

For some patients who may also have high blood pressure and swelling (edema), you may also be prescribed: 

• ACE inhibitors or ARB medicines (to treat high blood pressure)
• Diuretics or water pills (to treat fluid buildup)
• Limit sodium (salt) in your diet

Can MCD lead to kidney failure? 

Fortunately, MCD is less severe than other kidney diseases and rarely leads to kidney failure. Most patients recover fully and avoid relapses. In some cases, patients may have relapses of proteinuria, which will likely be treated the same way as the first time. 

*Minimal Change Disease. (2020, June 29). National Kidney Foundation. https://www.kidney.org/atoz/content/minimal-change-disease