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What is Minimal Change Disease?

Minimal Change Disease (MCD) with its another name Lipoid Nephrosis is a kidney problem which attacks children easily. It is one of the most common causes of Nephrotic Syndrome in children between the ages of 1 and 7 and accounts for the majority of this diagnosis. MCD is especially common among children, but it does not mean adults are insusceptible to this illness. According to clinical date, Minimal Change Disease accounts for about 15%-20% of adults diagnosed with Nephrotic Syndrome.

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Tests and Diagnosis of Minimal Change Disease

Several tests are used to diagnose Minimal Change Disease:

Routine Urine Test: The aim of this test is to know whether there are excess protein, red blood cells, urine specific gravity and PH and so on.

Quantity of 24h urine protein: This test has a precise response about the output of protein in urine and this can help to know about the severity of illness condition.

Routine Blood Test: With routine blood test, we can know clearly whether there are elevated serum creatinine level and blood urea nitrogen level. Both of these two measures are essential for learning about kidney condition. For patients with Minimal Change Disease, their serum creatinine level and blood urea nitrogen usually do not increase until a half of kidney function is impaired. Therefore, elevation of serum creatinine level and blood urea nitrogen level usually indicate serious kidney damages.

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How Is Minimal Change Disease Caused

To be honest, the pathogenesis of Minimal Change Disease is unclear, but clinical studies show that in Minimal Change Disease, the discharge barrier is impaired severely.

In our kidney, glomerular filtration membrane perform filtration function through mechanical barrier and charge barrier. As for charge barrier, it works by stopping substances with negative charge from leaking into urine. In our body, some protein carry negative charge, so with charge barrier, these protein can be kept in the body. However, for patients with Minimal Change Disease, their kidneys are injured and their charge barrier is damaged, and this can lead to leakage of useful substances like protein. As a result, various symptoms like proteinuria appear. Seeing from this aspect, restoring charge barrier is of great clinical significance for Minimal Change Disease patients to have a good recovery.

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Signs and Symptoms of Minimal Change Disease

For sufferers of Minimal Change Disease, they run a high risk for experiencing the following symptoms:

1. Foamy urine/bubbly urine: Foamy urine or bubbly urine occurs when large amounts of protein leak into urine. Charge barrier can help to preserve protein in the body, and when this barrier is damaged, lots of protein leak out and form proteinuria.

2. Fluid retention: Fluid retention is manifested as swelling or edema. In Minimal Change Disease, patients experience this symptom due to severe loss of protein in urine. When lots of protein are lost from urine, plasma osmotic pressure decreases. Under such a condition, fluid permeate into the surrounding tissues space, leading to swelling or edema.

The above two are the most commonly seen symptoms of Minimal Change Disease, however, they are not the all that patients experience. Without effective control, they may also suffer from high blood pressure and hematuria (blood urine). And when illness condition develops to kidney failure stage, more and more discomforts like tiredness, poor appetite, nausea, vomiting and itching will occur.

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Treatment Options for Minimal Change Disease

Minimal Change Disease is treated differently in different countries. The followings are the most commonly used treatment methods. Please remember to chose the right one according to specific illness condition:

Steroid Treatment: In this treatment, prednisone is often prescribed with hypotensive drugs like ACE inhibitor and this focuses on reducing protein in urine by reducing the blood pressure’s force which pushes the protein through the cell wall. With steroid treatment, symptoms of Nephrotic Syndrome go away quickly and patients can get a quick and good remission. However, the problem is Minimal Change Disease relapses easily with steroid treatment and lots of side effects will be caused if this treatment is used for a long time.

Immunotherapy: In Immunotherapy, Chinese medicine and western medicine are combined. They are used to achieve different purposes. For western medicine, they are excellent in remitting symptoms and reducing sufferings. Moreover, they work fast. As for Chinese medicines, they work relatively slowly, but they can adjust immune system, increase immunity and solve problems fundamentally. What is more, they are natural and cause no side effects with the right usage method. For Minimal Change Disease patients, by combining western medicine and Chinese medicine, not only treatment effects can be improved, side effects also can be avoided.

Dialysis and kidney transplant: Minimal Change Disease is relatively mild compared with many other kinds of kidney problem. However, this does not mean it can not progress to kidney failure. For Minimal Change Disease patients, they run an extremely high risk for kidney failure if their illness is left alone or treated improperly. Besides, dialysis and kidney transplant become the last two potions when kidneys are completely failed.

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Dietary Principles for Minimal Change Disease

Diet for Minimal Change Disease depends on patient’s exact illness condition, but they generally need to:

Adjust protein intake: A proper protein intake plays an important role in controlling illness condition. (Consult our online doctors about your protein intake for you or leave message to us to get suggestions about your protein intake )

Follow on low-salt diet: High salt diet not only elevates blood pressure, but also worsen swelling, so a low-salt diet is necessary.

Reduce fluid intake: Limitation of fluid intake is necessary for relieving fluid retention.

Have a low-fat diet: When large amounts of protein are lost from urine, live will produce some protein to meet the demand of our body. During this process, much more lipid will be produced, so a low-fat diet is suggested for patients with Minimal Change Disease.

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