For a better understanding of MCGN, please review Proteinuria first. |
What is it?
Who will be affected?
What are the symptoms?
What is the Natural course?
What is the Treatment?
Most of the time Minimal Change Glomerulo-Nephritis (MCGN) is a primary disease of the kidney ( not secondary to another illness in the patient). The kidneys are 'inflamed' and leak abnormal quantities of protein into the urine (Proteinuria) causing Nephrotic-Syndrome.
On occasion it could be a secondary disease of the kidneys due to other illnesses.
Following is the list of some of the illnesses that could cause MCGN:
1. Lymphomas
2. Cancer of various organs like kidneys, pancreas, lung etc.,
3. HIV (AIDS)
4. Medications: a. Lithium
b. Gold
c. Rifampin
d. Certain arthritis medications (NSAID)
e. Interferon
* Children below the age of 10 (2 to 5 per million per year)
* Boys predominate by
2:1
* Occurs less commonly
in adults (20% Vs 80% in children)
1. May not have any symptoms or may have one or more of
the following
2.
Fatigue
3.
Frothy urine
4.
Puffiness of face especially on waking up
5.
Swelling of legs (edema)
6.
Excessive flatulence and distention of the belly
7.
Shortness of breath especially on lying down
8.
Other symptoms depending on the cause (if any) of MCGN
9.
Symptoms of complications of MCGN:
Infections Formation of
Blood clots in the veins (DVT)
Heart Failure
* May resolve on its own without any treatment. How often does it resolve
without any treatment is not known. Such spontaneous resolution,
however, might take several years - exposing the patient to the
dangers of proteinuria. Therefore, treatment is rarely withheld.
* Overall has favorable prognosis, with patients rarely loosing
kidney function
requiring dialysis or kidney transplant.
* Almost always responds to treatment. But, at times, when the treatment is
stopped the disease occurs once again in some.
Treatment: (For a better understanding of the treatment
Please review the treatment of Proteinuria)
1. If the quantity of protein in the urine is less than 1500 mgs per 24 hrs
and blood protein level is normal with no symptoms, patients could be
observed without any treatment for several months. If the protein in the
urine does not resolve during such observation, in order to prevent long
term dangers of proteinuria, patients may be treated.
2. Treatment involves:
a. Treatment of high blood pressure (Hypertension) if present
b. Treatment of the swelling with Diuretics and salt restricted
diet
c. Medications:
Some of the medications that might be used to cure or control
MCGN are:
Prednisone Cyclosporin
Chlorambucil
ACE-inhibitors
AT1-receptor
blockers Cytoxan
Imuran
Cellcept
d. Treatment of complications of MCGN
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