Board Review Bonus #2: Minimal Change Disease

GN in Ten

In this special bonus episode of the podcast, Koyal and Kenar provide a maximally useful review of minimal change disease, from diagnosis (including secondary causes to screen for) to treatment options, including how to decide which patients may do better with which therapies.

Can’t get enough minimal change? Check out Episode 6 (with Astrid Weins) and Episode 7 (with Felicitas Hengel and Nicola Tomas) for more on the potential role of anti-nephrin autoantibodies in MCD.

References

KDIGO guidelines: https://kdigo.org/wp-content/uploads/2017/02/KDIGO-GD-Guideline-Key-Takeaways-for-Clinicians-Minimal-Change-Disease.pdf

Anti-nephrin autoantibodies:

Kronbichler A, Barnini C, Matyjek A, Gauckler P, Bruchfeld A, Caravaca-Fontan F, Floege J, Frangou E, Mirioglu S, Moran SM, Stevens KI, Teng YKO, Steiger S. Antibody-mediated podocytopathies: a disease entity that implies immunotherapy. Nephrol Dial Transplant. 2024 Jul 17:gfae166. doi: 10.1093/ndt/gfae166. Epub ahead of print. PMID: 39020250.

Hengel FE, Dehde S, Lassé M, Zahner G, Seifert L, Schnarre A, Kretz O, Demir F, Pinnschmidt HO, Grahammer F, Lucas R, Mehner LM, Zimmermann T, Billing AM, Oh J, Mitrotti A, Pontrelli P, Debiec H, Dossier C, Colucci M, Emma F, Smoyer WE, Weins A, Schaefer F, Alachkar N, Diemert A, Hogan J, Hoxha E, Wiech T, Rinschen MM, Ronco P, Vivarelli M, Gesualdo L, Tomas NM, Huber TB; International Society of Glomerular Disease. Autoantibodies Targeting Nephrin in Podocytopathies. N Engl J Med. 2024 May 25. doi: 10.1056/NEJMoa2314471. Epub ahead of print. PMID: 38804512.

Watts AJB, Keller KH, Lerner G, Rosales I, Collins AB, Sekulic M, Waikar SS, Chandraker A, Riella LV, Alexander MP, Troost JP, Chen J, Fermin D, Yee JL, Sampson MG, Beck LH Jr, Henderson JM, Greka A, Rennke HG, Weins A. Discovery of Autoantibodies Targeting Nephrin in Minimal Change Disease Supports a Novel Autoimmune Etiology. J Am Soc Nephrol. 2022 Jan;33(1):238-252. doi: 10.1681/ASN.2021060794. Epub 2021 Nov 3. PMID: 34732507; PMCID: PMC8763186.