Biopsy of Minimal Change Disease

Minimal Change Disease is a term on the basis of renal biopsy. It is the first level of IgA Nephropathy according to the Haas Classification. In minimal change level, there is slight mesangial cell proliferation in glomeruli; no segmental sclerosis, no necrosis and no crescent. In clinical classification, it belongs to nephrotic syndrome.
The summit age for children with minimal change is 2 to 6 years old. Adult people start to suffer from this when they are 30 to 40 years old in most of time. Among those who are more than 60 years old with nephrotic syndrome, minimal change takes up a large proportion.
As for the children with minimal change, boys are twice as many as girls. And as for adults, the ratio is nearly one to one. About one third of them have had infection such as infection in upper respiratory tract, most of which start in a rapid speed, the initial symptoms are nephrotic syndrome. Among nephrotic syndrome, children take up a large proportion and adults only take up 20%. Their blood pressure is normal.
20% of patients with minimal change have different degree of microscopic hematuria. With time passing by, the ratio increases as well. especially among those who are more than 60 years old, the rate of microscopic hematuria is also higher due to the fibrosis of renal interstitial areas. However, hematuria is rarely seen among minimal change. Due to the decrease of blood content and perfusion in the kidney, about one thirds patients have had decreased glomerular filtration rate before they go to see a doctor. For some serious cases, the protein in urine can be more than 40g.
If it develops further, it will develops into FSGS Change. Glomeruli appear to have pathological change similar to idiopathic focal segmental glomerulosclerosis, accompanied by slight glomerular mesangial cells hyperplasia; No crescent or necrosis.
So effective treatment is important. In western contries, hormones and antibiotics are widely used, which now has proved to have side effects and can not treat fundamentally. In China, patients with minimal change are suggested to adopt Chinese Medicine, which can repair the damage intrinsic cells and recover renal function.