Minimal change glomerulonephritis is a special type of glomerulonephritis. The disease is also referred to by some doctors with the abbreviation MCGN. Minimal change glomerulonephritis is a disease that occurs primarily in young children.
What is minimal change glomerulonephritis?
In many cases, minimal-change glomerulonephritis is the trigger for the so-called nephrotic syndrome, which affects some children. Minimal change glomerulonephritis occurs with particular frequency in children between the ages of two and six. About 90 percent of all diseases with this syndrome take place at this age. See AbbreviationFinder for abbreviations related to MCGN.
In comparison, it is only 10 to 15 percent in adult patients. Some medical professionals advocate calling minimal-change glomerulonephritis minimal-change glomerulopathy because the disease lacks certain characteristics of inflammation. Basically, minimal-change glomerulonephritis is a disease that mainly affects the kidney corpuscles.
While the functioning of the kidneys is unaffected by the disease in most cases in children, some adults show a slight decrease in kidney function. In rare cases, acute organ failure occurs.
Causes
Various factors are discussed as causes of minimal-change glomerulonephritis. In the majority of cases it is an idiopathic disease. This means that the specific causes for the development of minimal change glomerulonephritis cannot be identified and are therefore unknown. It is therefore the exception rather than the rule that the causes of the disease can be identified in a patient.
Certain medications, such as non-steroidal anti -inflammatory drugs, are possible triggers. But active ingredients such as interferon, ampicillin and lithium are also responsible for some of the cases of the disease. In addition, some diseases favor the development of minimal-change glomerulonephritis. Examples include leukemia and Hodgkin’s disease.
In addition, the disease sometimes occurs in connection with carcinomas of the kidney cells or the pancreas and together with thymomas. Minimal-change glomerulonephritis may also be present in connection with carcinomas of the prostate. Some assumptions assume that the cells of the tumors secrete special cytokines. In principle, however, a joint occurrence with carcinomas is comparatively rare.
Symptoms, Ailments & Signs
The symptoms associated with minimal-change glomerulonephritis are diverse and may differ slightly in the affected patients. The main symptom of the disease is the nephrotic syndrome, which occurs acutely. It manifests itself in proteinuria as well as hypoprotein and hyperlipoproteinemia. In addition, edema as a result of hypoalbuminemia is possible.
The proportion of the substance creatinine in the serum of the blood is usually not abnormal in children. In adults, however, the concentration may be slightly increased. In addition, adult patients often show an increase in blood pressure. In rare cases, the kidneys of those affected fail acutely.
Diagnosis & disease progression
Minimal change glomerulonephritis is diagnosed with the help of various examination methods. In any case, if a person shows the typical symptoms of minimal-change glomerulonephritis, they should see a doctor as soon as possible. This examines the present complaints, whereby he first carries out an anamnesis with the affected patient.
With regard to the clinical examination, for example, analyzes of the tissue of the kidneys are used. The corresponding tissue comes from a puncture of the kidney. It is also possible to use an electron microscope to examine the tissue samples. This shows typical signs of minimal-change glomerulonephritis. An analysis of the urine is also essential, whereby numerous symptoms of the disease can be detected. A kidney biopsy usually confirms the diagnosis of minimal-change glomerulonephritis.
Complications
Most cases of minimal-change glomerulonephritis only occur in young children. Those affected suffer from severely elevated blood pressure. This complaint can have a negative effect on the patient’s health and lead to various other complaints. In the worst case, high blood pressure can also lead to a heart attack and death.
It is also not uncommon for spontaneous bleeding or a bloody taste in the mouth, which occurs especially under high stress. Furthermore, minimal-change glomerulonephritis can lead to kidney problems, so that in the worst case those affected suffer from kidney failure. This needs to be treated urgently, otherwise the patient will die. During treatment, the affected person is primarily dependent on dialysis, with the aim of transplantation of a kidney.
Life expectancy is also significantly reduced as a result of minimal-change glomerulonephritis. As a rule, the disease can be cured very well with the help of medication, so that the symptoms disappear completely and are limited. There are no other complications. A new treatment can also be carried out in the event of a recurrence.
When should you go to the doctor?
Discomfort when urinating as well as tiredness and exhaustion are often signs of a health problem. If the symptoms persist or increase in intensity, a doctor is needed. Low blood pressure, pale complexion or listlessness are indications of an existing irregularity that needs to be monitored further. If high blood pressure develops later on, a medical examination is necessary. If you experience wheezing, reduced physical performance, or reduced participation in social activities, you need a doctor. The disease occurs mostly in children, so that special features in the behavior of the offspring should be discussed with a doctor. In case of irritability, depressive states,
If the kidneys malfunction, you should see a doctor as soon as possible. Organ failure is a potentially life-threatening condition that should be avoided. The development of oedemas, swellings on the body or changes in the appearance of the skin must be examined and treated. If there are circulatory disorders, noticeable weight changes or a general feeling of illness, a doctor should be consulted. If an acute critical condition arises, an emergency service must be alerted. First aid measures must be applied immediately to ensure the survival of the victim.
Treatment & Therapy
In the majority of cases, glucocorticoids show very good results in the therapy of minimal-change glomerulonephritis. In more than 90 percent of patients, proteinuria disappears completely after ingestion. In particular, children react well to the corresponding active ingredient. For this reason, they usually do not have a kidney biopsy performed.
In children, improvement usually occurs after a few weeks. The situation is different in adult patients, for whom it sometimes takes a few months before treatment with the active ingredient shows any success. A kidney biopsy is mandatory here. As soon as the condition of the affected persons and in particular the proteinuria improves, the dose of glucocorticoids is gradually reduced.
However, proteinuria recurs in a majority of affected patients even after successful treatment. A small number of people suffering from minimal-change glomerulonephritis will develop terminal kidney weakness within the next two decades. The medicinal substance prednisone is often used in childhood patients.
The dose is comparatively high at the beginning of administration. After a certain time, the doctor reduces the dosage of the drug. This type of therapy usually shows success in the child patients after a month at the latest. However, many people relapse.
Outlook & Forecast
In principle, a favorable prognosis can be assumed. Minimal change glomerulonephritis can even heal on its own. Statistically, this is the case in four out of ten children under the age of ten. One treatment leads to a complete cure in one third of those affected. For the rest, minimal-change glomerulonephritis persists for life. Complications cannot be ruled out. Medications are to be taken continuously. The quality of life sometimes suffers from the existing complaints. However, if the disease only occurs in adulthood, the prognosis is usually poorer. The treatment period until the drugs and therapeutic approaches are effective is also increasing.
Two aspects are proving to be problematic, which may worsen the prospects. On the one hand, minimal-change glomerulonephritis recurs in some cases. The recurrence rate is about 30 percent after successful therapy. On the other hand, a good five percent of all patients develop terminal renal failure over a period of 25 years. This can end fatally. Both can only be countered by consistent follow-up care, which means that patients never finally get rid of minimal-change glomerulonephritis. This risk can represent a psychological burden in everyday life.
Prevention
Minimal-change glomerulonephritis can only be prevented to a limited extent, because the specific causes of the disease are often unclear in individual cases.
Aftercare
The symptoms can usually be alleviated or even completely cured with medication, so that those affected can live with the disease. The disease does not bring any other complications. If it recurs, the same treatment is applied. Those affected should generally strive for a healthy lifestyle with sufficient sleep and exercise and pay attention to a balanced diet. Moderate exercise increases the immune system and contributes to general well-being. If those affected suffer from renal insufficiency, they are dependent on regular monitoring by the attending physician in order to avoid further complications. Sometimes the life expectancy of those suffering from minimal-change glomerulonephritis is significantly reduced.
You can do that yourself
There are no known self-help options for minimal-change glomerulonephritis, so the disease must always be examined and treated by a doctor. Only by taking medication can the symptoms be completely alleviated and the disease combated. In children, a biopsy of the kidney is usually not necessary and the symptoms disappear after a few weeks. Adults, however, need a biopsy, and minimal-change glomerulonephritis in adults can take several months to heal.
Because the disease can cause lasting damage to the kidneys, patients need regular check-ups to avoid further complications. Since the causes of minimal-change glomerulonephritis are still unclear, the disease cannot be prevented directly. If the disease leads to high blood pressure, blood- thinning medication can be taken after consulting a doctor. It is advisable to check your blood pressure regularly.
In the case of psychological complaints, talking to other people affected by minimal-change glomerulonephritis often helps, as this can lead to an exchange of information. Furthermore, talking to your own friends or family is very helpful to prevent depression and other mental upsets.
