Minimal Change Disease

Minimal change disease (MCD) is a podocytopathy that is the main cause of nephrotic syndrome in childhood (up to 90% of cases), being less frequent in adults (10–15%). The pathogenesis of the disease includes the interaction of several factors, such as genetics—mutations that cause structural or functional abnormalities in podocytes—and direct toxicity of these components, occasionally triggered by infectious, inflammatory, and hematological disorders and drugs, among others. In addition, there is a dysregulation of adaptive immunity, including a functional and distribution imbalance of the different subtypes of T and B lymphocytes. MCD has a good response to corticosteroid treatment, especially in pediatric patients, but recurrences are frequent. The natural history of the disease may vary widely, but proteinuria is the cardinal prognosis factor in renal outcome.