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FR vs SD MCD Definitions — ESENeph MCQ

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EasyGlomerulonephritisFR vs SD MCD DefinitionsESENeph

A 30-year-old woman presents with nephrotic syndrome. Her biopsy shows minimal change disease. She responds to steroids but relapses within 2 weeks of steroid taper. This is her 3rd relapse in 12 months. She meets the definition of which MCD category?

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Correct answer: C — Frequently relapsing MCD – defined as ≥2 relapses within 6 months of initial response or ≥4 relapses in any 12-month period; steroid-dependent MCD is defined as relapse during taper or within 14 days of stopping steroids – she may also qualify as steroid-dependent

KDIGO 2021 GN guideline defines: (1) Frequently relapsing (FR) MCD: ≥2 relapses within 6 months of initial response or ≥4 relapses in any 12-month period; (2) Steroid-dependent (SD) MCD: relapse during steroid taper or within 14 days of steroid cessation. These definitions guide second-line agent selection. This patient has 3 relapses in 12 months (meets FR criteria) and relapses within 2 weeks of taper (meets SD criteria). Both FR and SD MCD warrant steroid-sparing agents (Rituximab, Cyclophosphamide, CNIs, or MMF) to avoid cumulative steroid toxicity.

Reference: KDIGO 2021 – Glomerular Disease Guideline