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Minimal Change Disease — RACP Adult Medicine MCQ

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EasyNephrologyMinimal Change DiseaseRACP Adult Medicine

A 6-year-old boy presents with periorbital oedema, heavy proteinuria (nephrotic range), hypoalbuminaemia (18 g/L), and hyperlipidaemia. Urinalysis shows no haematuria. Complement levels are normal. What is the most likely diagnosis?

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Correct answer: E — Minimal change disease

Nephrotic syndrome in a child with bland urinary sediment (no haematuria) and normal complement is most likely minimal change disease. It accounts for >75% of nephrotic syndrome in children. The key feature is selective proteinuria. Responds to oral prednisolone in >90% of cases. Kidney biopsy shows effacement of podocyte foot processes on EM.

Reference: KDIGO – 2021 – Glomerular Disease Guidelines