Go back to clinical information and images

Diagnosis: Minimal Change Disease and Secondary Acute Tubular Damage

Approximately 25% of patients with minimal change disease (MCD) present acute kidney injury (AKI) at some point in their evolution. Although the mechanism responsible for the low GFR at presentation is not well understood, several not mutually exclusive factors may contribute: reduced glomerular permeability due to foot process fusion, low serum albumin concentration, transient ischemic tubular injury, interstitial edema, diuretic therapy, nonsteroidal anti-inflammatory drugs, and contrast media toxicity. Patients with MCD who develop AKI tend to have more marked proteinuria and hypoalbuminemia and a higher blood pressure than those who maintain relatively normal renal function. They also tend to be much older (Meyrier A. Acute kidney injury (AKI) in minimal change disease and other forms of nephrotic syndrome. In UpToDate (consulted on March 19th) [Link] ).

See the chapter: Minimal Change Disease of our Tutorial.

Go back to clinical information and images

References

• Meyrier A. Acute kidney injury (AKI) in minimal change disease and other forms of nephrotic syndrome. In UpToDate (consulted on March 19th) [Link]
• Rheault MN, Wei CC, Hains DS, Wang W, Kerlin BA, Smoyer WE. Pediatr Nephrol. Increasing frequency of acute kidney injury amongst children hospitalized with nephrotic syndrome. 2014;29(1):139-47. [PubMed link]
• Ueda K, Hirahashi J, Seki G, Tanaka M, Kushida N, Takeshima Y, Nishikawa Y, Fujita T, Nangaku M. Successful treatment of acute kidney injury in patients with idiopathic nephrotic syndrome using human atrial natriuretic Peptide. Intern Med. 2014;53(8):865-9. [PubMed link]
• Tavares MB, Chagas de Almeida Mda C, Martins RT, de Sousa AC, Martinelli R, dos-Santos WL. Acute tubular necrosis and renal failure in patients with glomerular disease. Ren Fail. 2012;34(10):1252-7 [PubMed link]

[Top]

Go back to clinical information and images