Proteinuria predicts relapse in adolescent and adult minimal change disease

This study sought to outline the clinical and laboratory characteristics of minimal change disease in adolescents and adults and establish the clinical and laboratory characteristics of relapsing and non-relapsing patients. We retrospectively evaluated patients with confirmed diagnoses of minimal ch...

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Published in:Clinics (São Paulo, Brazil) Brazil), 2012-11, Vol.67 (11), p.1271-1274
Main Authors: Dias, Cristiane Bitencourt, Pinheiro, Cilene Carlos, dos Santos Silva, Vanessa, Hagemann, Rodrigo, Barros, Rui Toledo, Woronik, Viktoria
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adults
Clinical Science
Female
Hematuria - diagnosis
Hematuria - urine
Humans
Male
MEDICINE, GENERAL & INTERNAL
Middle Aged
Minimal Change Disease
Nephrosis, Lipoid - diagnosis
Nephrosis, Lipoid - drug therapy
Nephrosis, Lipoid - urine
Proteinuria
Proteinuria - diagnosis
Proteinuria - urine
Recurrence
Relapse
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome
Young Adult
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Summary:This study sought to outline the clinical and laboratory characteristics of minimal change disease in adolescents and adults and establish the clinical and laboratory characteristics of relapsing and non-relapsing patients. We retrospectively evaluated patients with confirmed diagnoses of minimal change disease by renal biopsy from 1979 to 2009; the patients were aged >13 years and had minimum 1-year follow-ups. Sixty-three patients with a median age (at diagnosis) of 34 (23-49) years were studied, including 23 males and 40 females. At diagnosis, eight (12.7%) patients presented with microscopic hematuria, 17 (27%) with hypertension and 17 (27%) with acute kidney injury. After the initial treatment, 55 (87.3%) patients showed complete remission, six (9.5%) showed partial remission and two (3.1%) were nonresponders. Disease relapse was observed in 34 (54%) patients who were initial responders (n = 61). In a comparison between the relapsing patients (n = 34) and the non-relapsing patients (n = 27), only proteinuria at diagnosis showed any significant difference (8.8 (7.1-12.0) vs. 6.0 (3.6-7.3) g/day, respectively, p = 0.001). Proteinuria greater than 7 g/day at the initial screening was associated with relapsing disease. In conclusion, minimal change disease in adults may sometimes present concurrently with hematuria, hypertension, and acute kidney injury. The relapsing pattern in our patients was associated with basal proteinuria over 7 g/day.
ISSN:1807-5932
1980-5322
1980-5322
DOI:10.6061/clinics/2012(11)08