Signs and Symptoms

A patient suffering from Minimal Change Disease will not experience any symptoms until the disease progresses to nephrotic syndrome and too much of the protein in their body is being lost into the urine.  Some of the major symptoms that a patient will notice once their body is in nephrotic syndrome and may cause them to seek treatment are as follows:

• Swelling.  You may hear the phrase 'pitting edema.'  Edema refers to the retention of fluid and swelling of the body.   'Pitting' refers to the way that the swelling is measured.  When a healthcare worker presses into the swollen area, their fingertip will leave a 'pit' that will not immediately disappear.

• Stretch marks (known medically as skin striae [STRY-ay]) are bands or lines on the skin that are due to a rapid growth.  The skin stretches to allow more space in the body.

• They can't pee!  Or at least the patient is not urinating very often.  This is called 'oliguria.' 

• Shortness of breath and chest pain.  Some of the fluid that is being kept in the body may get into the space between the lung and the lung cavity.  In a healthy person, this space is a negative pressure area which keeps the lung expanded.  Too much fluid in the potential space will cause the lung to collapse resulting in shortness of breath and pain in the chest.

• Often times, the fluid that is being retained will result in swelling specifically in the abdomen.  This is known as ascites (Uh-SIGH-tees) and it will look something like this...

• There may be an  unexplained, general weight gain.

• The individual may complain of a headache, fatigue and/or be irritable.

• Meuhrcke's lines - these lines are white bands that run parallel to one another and perpendicularly across the fingernail.  They are a result of low protein in the body.

• Anorexia.  This is just a general term for a loss of appetite or an inability to eat.

• Foamy or frothy urine.  This is caused by an excessive amount of protein being leaked into the urine. 

Signs of MCD

The main sign that medical professionals will be looking for is the presence of protein in the urine, otherwise known as proteinuria.  Healthy people will excrete a small amount of protein daily, however, once that amount is above a certain number (150mg for adults and 29-238mg for children) it is a medical problem and indicative of nephrotic syndrome.  The tentative diagnosis is then confirmed through a kidney biopsy.



References:

 http://web.b.ebscohost.com.offcampus.lib.washington.edu/ehost/pdfviewer/pdfviewer?vid=4&sid=15a322f7-c41c-48cc-8fc6-90a0fdbcaed7%40sessionmgr115&hid=125

https://www.kidney.org/atoz/content/nephrotic

http://www.merckmanuals.com/professional/genitourinary_disorders/glomerular_disorders/overview_of_nephrotic_syndrome.html