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Minimal change disease - Treatment

Alternative Names

Minimal change nephrotic syndrome; Nil disease; Lipoid nephrosis; Idiopathic nephrotic syndrome of childhood

Treatment:

Corticosteroids can cure minimal change disease in most children. Some patients may need to stay on steroids to keep the disease in remission.

Adults do not respond to steroids quite as well as children, but many still do find steroids effective. Adults may have more frequent relapses and steroid dependence.

Patients who have three or more relapses may do better with cytotoxic therapy. In most cases, this involves a medication called cyclophosphamide. Other medicines that have been used include cyclosporine and chlorambucil.

Swelling may be treated with:

  • ACE inhibitor medicines
  • Blood pressure control
  • Diuretics (water pills)

You may also be told to reduce the amount of salt in your diet.

Expectations (prognosis):

Minimal change disease usually responds well to corticosteroids, often within the first month. A relapse can occur, but patients may improve after prolonged treatment with corticosteroids and medications that suppress the immune system (immunosuppressive medications).

Complications:

Calling your health care provider:

Call for an appointment with your health care provider if you develop symptoms of minimal change disease.

If you have this disorder, call for an appointment with your health care provider if your symptoms worsen or you develop new symptoms, including side effects from the medications used to treat the disorder.

  • Reviewed last on: 11/30/2009
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Herbert Y. Lin, MD, PHD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 122.

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