Adult minimal change disease with acute kidney injury: a case report and literature review

Nicholas, P. Daniel; Garrahy, Ian

doi:10.1080/20009666.2019.1688125

Cited by 7 publications

(8 citation statements)

References 11 publications

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“…The progression of MCD is related to a combination of ischemic injury, tubular injury, and diminished capillary filtration [ 22 , 23 ]. In an in vitro study, hyperuricemia decreased the expression of E-cadherin in epithelial cells resulting in a loss of cell-to-cell contact in the renal tubular cells of rats [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia is a risk factor for the progression to end-stage renal disease in minimal change disease

Song

Choi

et al. 2021

Kidney Res Clin Pract

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Background Minimal change disease (MCD) is one of the most common causes of nephrotic syndrome worldwide. Hyperuricemia increases the end-stage renal disease (ESRD) risk in glomerulonephritis. In this study, we aimed to determine the effect of high serum uric acid levels on the progression to ESRD in MCD. Methods A total of 800 patients diagnosed with MCD by kidney biopsy were retrospectively analyzed. We determined the relationship of hyperuricemia with the progression to ESRD in MCD using the Cox proportional hazard model and Kaplan-Meier survival analysis. The primary outcome was defined as the initiation of dialysis or kidney transplantation. Results A total of 42 patients (5.3%) progressed to ESRD during the follow-up period. In the restricted cubic spline curve, serum uric acid levels exhibited a positive correlation with ESRD progression in patients with MCD. In the fully adjusted model, the risk of MCD progression increased by 29% for every 1 mg/dL increase in the baseline serum uric acid level (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.09–1.54; p = 0.004). Falling into the high uric acid group (serum uric acid level > 7 mg/dL in men and > 6 mg/dL in women) was also a risk factor for progression of MCD to ESRD (HR, 3.40; 95% CI, 1.59–7.31; p < 0.001). Conclusion Our study shows that hyperuricemia is an independent risk factor for the progression to ESRD in patients with MCD.

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Section: Discussionmentioning

confidence: 99%

Hyperuricemia is a risk factor for the progression to end-stage renal disease in minimal change disease

Song

Choi

et al. 2021

Kidney Res Clin Pract

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“…In cases of primary nephrotic syndrome, MCD is most likely associated with AKI, and 25% of adult cases of MCD are complicated by AKI [ 7 ]. Risk factors for AKI in MCD patients include advanced age, hypertension, urinary protein (11.6 ± 0.6 g/day), and hypoalbuminemia (1.9 ± 0.1 g/dL) [ 8 - 10 ]. The causes of AKI in MCD patients are diverse; however, intravascular dehydration and decreased renal blood flow associated with hypoalbuminemia, and consequent tubular necrosis are notable [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Caused by Renin-Angiotensin System Inhibitors During Minimal Change Disease Treatment

Torigoe¹,

Ikemi²,

Yoshida³

et al. 2022

Cureus

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A 76-year-old Japanese man with nephrotic syndrome was admitted to our department for treatment. After his admission, he was administered prednisolone (PSL) at 40 mg/day, and a percutaneous renal biopsy was performed. However, on the first day of admission, his urinary protein decreased from 5.05 g/gCr to 1.85 g/gCr. On the fourth day of admission, his urinary protein further decreased to 0.38 g/gCr and the patient developed acute kidney injury (AKI). Renin-angiotensin system (RAS) inhibitors were suspected to be the cause of AKI; therefore, they were discontinued. After the renal function improved, the urinary protein worsened again to 5.49 g/gCr. Renal pathology suggested minimal change disease (MCD); therefore, PSL was continued. The patient's urinary protein subsequently improved and he had no renal function impairment. Minimal change disease can be complicated by AKI through intravascular volume depletion caused by high urinary protein and hypoalbuminemia. However, when MCD is complicated by RAS inhibitor-associated AKI, the urinary protein may notably decrease, and the patient may present with an atypical course of MCDassociated AKI.

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“…Corticosteroid is a standard therapy for MCD but 10%–30% of adults with MCD may not respond to the treatment. In these patients, immunosuppressive therapy such as cyclosporin is recommended ( 1 , 2 ). Acute pulmonary embolism associated with MCD in adults is very rare ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Acute pulmonary embolism with arrhythmia associated with minimal change disease in adults: a case report

Cui

Liu

Wang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundMinimal change disease (MCD) is a common pathological type of nephrotic syndrome (NS), and is one of the most common causes of NS in children, but is not common in adults. MCD is sensitive to corticosteroid therapy and has a good prognosis, but is prone to relapse. Venous thromboembolism (VTE) is less common in MCD.Case presentationWe report a case of acute pulmonary embolism (PE) with arrhythmia associated with MCD in adults. The hypercoagulable state caused by MCD through multiple systems may be one of the important causes of thrombosis in this patient. In addition to the conventional corticosteroid therapy, he was started on anticoagulation for VTE and PE. His hospital course was complicated by atrial tachyarrhythmias initially controlled by amiodarone but he required readmission due to recurrent atrial flutter. His clinical condition became more stable after radiofrequency ablation.ConclusionVTE associated with MCD in adults is rare. Treatment of MCD with corticosteroids may be associated with a higher risk of developing blood clots. This type of case is relatively rare and should be paid attention to. The mechanism of VTE in MCD is still a direction worthy of further research.

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Adult minimal change disease with acute kidney injury: a case report and literature review

Cited by 7 publications

References 11 publications

Hyperuricemia is a risk factor for the progression to end-stage renal disease in minimal change disease

Hyperuricemia is a risk factor for the progression to end-stage renal disease in minimal change disease

Acute Kidney Injury Caused by Renin-Angiotensin System Inhibitors During Minimal Change Disease Treatment

Acute pulmonary embolism with arrhythmia associated with minimal change disease in adults: a case report

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