ABSTRACT
Nephrotic syndrome develops when an abnormality of glomerular permeability results in the development of heavy proteinuria, hypoalbuminaemia and generalised oedema. Large studies in the 1970’s reported that 80% of cases of childhood nephrotic syndrome are attributable to minimal change disease (MCD), so called because renal biopsy shows no significant abnormality at light microscopy level. This disorder is more common in males than females (ratio 3:2) and is predominantly a disease of younger children with a median age at presentation of 3 years. The incidence of MCD, in the UK, is around 2–4 per 100,000 children in the Caucasian population, but is approximately six times higher in children of Asian origin [1]. MCD is associated with response to oral steroid therapy in over 90% of cases and is usually associated with a favourable long-term outcome, although at least 70% of patients will experience a chronic, relapsing-remitting course [2, 3].
