Minimal change disease: current trends and therapeutic options

Minimal change disease (MCD) is the major cause of nephrotic syndrome (NS), especially in children, and is distinguished by podocyte foot process effacement observable under electron microscopy, resulting in proteinuria, hypoalbuminemia, and hyperlipidemia. While the cause is unknown, immunological dysregulation, notably T-cell dysfunction and inflammatory cytokines such as IL-4 and IL-13, plays a critical role in podocyte damage. MCD has a high steroid sensitivity rate in children and adults. Secondary causes include allergies, cancer, medications, infections, and autoimmune disorders. Electron microscopy is used for diagnosis, and developing noninvasive indicators, such as urine CD80, shows promise. Corticosteroids are used as the first line of treatment, although steroid-resistant or dependent instances may require calcineurin inhibitors, rituximab, or cyclophosphamide instead. Long-term outcomes are generally positive, yet untreated cases can lead to serious consequences such as kidney failure. Future research will focus on proteomics for diagnostic biomarkers and targeted therapeutics to improve management.