The rarity of minimal change disease in Nigerian patients with the nephrotic syndrome

Abstract

Minimal change disease (MCD), mesangial proliferative glomerulonephritis (MPGN) and focal glomerulosclerosis (FGS) may be indistinguishable at some stage when examined by light microscopy, but MCD in adults has over 80% response rate to prednisolone therapy. In search of MCD, we treated 22 patients with biopsy reported MCD (1 patient), MPGN (15 patients), and FGS (6 patients), out of 84 adult patients with the nephrotic syndrome (NS) seen over 55 months, with prednisolone 60mg daily for 6 weeks (4 patients) or 8 weeks (18 patients). Two patients with MPGN showed partial remissions with proteinuria dropping to 0.8g/24 hours and 1.2g/24 hrs. All the others were non-responsive with proteinuria remaining above 2g/24 hours. Allowing that 20% of patients may not respond to prednisolone, 4 patients may have been missed. It is concluded that MCD as defined by minor glomerular changes and good response to steroids is rare in adult Nigerian patients with the NS