What are the recommended management strategies for a patient with minimal change disease?

For a patient diagnosed with minimal change disease (MCD), the recommended management strategies primarily focus on inducing remission of nephrotic syndrome and managing associated complications ¹,³. MCD is a common cause of nephrotic syndrome, particularly in infants and children (Downie et al., 2017).

The cornerstone of treatment for MCD is typically corticosteroid therapy (Downie et al., 2017). This approach targets the underlying immune dysregulation and podocyte dysfunction that characterise the disease (Roman and Nowicki, 2024).

Beyond specific immunosuppression, general management principles for nephrotic syndrome and chronic kidney disease are crucial ¹,³. These include:

• Monitoring kidney function: Regular assessment of kidney function is essential to track disease progression and treatment response ¹,³.
• Managing complications: Patients may require supportive care to address complications such as oedema, infections, and thrombosis, which are common in nephrotic syndrome (Downie et al., 2017).
• Blood pressure control: Maintaining healthy blood pressure is important for kidney health ¹,³.
• Dietary advice: This may include managing fluid and salt intake to control oedema (Downie et al., 2017).

Long-term management involves monitoring for relapses and considering alternative immunosuppressive agents if the patient is steroid-resistant or frequently relapsing (Downie et al., 2017).