Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 22-15: Minimal Change Disease + Key Features Download Section PDF Listen +++ ++ Nephrotic range proteinuria Most common in children; occurs occasionally in adults Can be idiopathic May also occur Following viral upper respiratory infections (especially in children) In association with neoplasms, such as Hodgkin disease With drugs (lithium) With hypersensitivity reactions (especially to nonsteroidal anti-inflammatory drugs and bee stings) + Clinical Findings Download Section PDF Listen +++ ++ Nephrotic syndrome + Diagnosis Download Section PDF Listen +++ ++ Biopsy should be considered for children With nephrotic syndrome who exhibit unusual features (such as signs of other systemic illness) Who are corticosteroid-resistant Who relapse upon withdrawal of corticosteroid therapy Kidney biopsy Light microscopy and immunofluorescence: no changes Electron microscopy: characteristic effacement of podocyte foot processes + Treatment Download Section PDF Listen +++ ++ Prednisone, 60 mg/m2/day orally Can take up to 16 weeks for patient to respond to treatment Continue for several weeks after complete remission of proteinuria Cyclophosphamide, a calcineurin inhibitor, or rituximab for patients with corticosteroid resistance or relapses Progression to end-stage renal disease is rare Complications most often related to prolonged corticosteroid use