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Minimal change disease in adult nephrotic syndrome — RACP Adult Medicine MCQ

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ModerateNephrologyMinimal change disease in adult nephrotic syndromeRACP Adult Medicine

A 31-year-old man develops sudden oedema after an upper respiratory infection. Albumin is 21 g/L, urine protein-creatinine ratio is 510 mg/mmol and creatinine is normal. Urine sediment is bland and complements are normal. What is the most likely diagnosis?

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Correct answer: D — Minimal change disease

Abrupt nephrotic syndrome with bland sediment and normal renal function is compatible with minimal change disease, though adults often still require biopsy confirmation. IgA nephropathy and post-streptococcal GN usually produce haematuria. Interstitial nephritis and renal colic do not cause heavy proteinuria with hypoalbuminaemia.

Reference: Kidney Health Australia/CARI Guidelines; AMH