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Minimal change disease — RACP Paediatrics MCQ

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EasyNephrologyMinimal change diseaseRACP Paediatrics

A 4-year-old presents with facial puffiness, abdominal distension, and frothy urine. Urine dipstick shows 4+ protein. Blood tests show albumin 12 g/L, cholesterol 10 mmol/L, and normal creatinine. Urine protein:creatinine ratio is 800 mg/mmol. What is the most likely underlying pathology?

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Correct answer: B — Minimal change disease

Nephrotic syndrome (heavy proteinuria, hypoalbuminaemia, hyperlipidaemia, oedema) in a child aged 1-10 years is most commonly due to minimal change disease (>80% of cases). It is highly responsive to corticosteroid therapy. First-line treatment is prednisolone 60 mg/m²/day (max 80 mg) for 4 weeks then 40 mg/m² alternate days with tapering (per KDIGO 2021).

Reference: RCH Melbourne – 2023 – Nephrotic Syndrome CPG; KDIGO – 2021 – Nephrotic Syndrome in Children