Adult Minimal Change Disease (KDIGO 2021 Guidelines)
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Adult Minimal Change Disease (KDIGO 2021 Guidelines)
- 1. Adult Minimal Change Disease KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases Mohammed Abdel Gawad MD Neph, ESENeph Lecturer of Nephrology, School of Medicine, NewGiza University Nephrology Consultant, Alexandria Founder of NephroTube.com Co-chair of AFRAN Web/Media Committee ISN Education SoMe Team Member drgawad@gmail.com @Gawad_Nephro 29, June, 2022
- 3. To download the lecture contact me drgawad@gmail.com For more Nephrology lectures visit www.NephroTube.com
- 4. Clin J Am Soc Nephrol 12: 332–345, February, 2017
- 5. Clin J Am Soc Nephrol 12: 332–345, February, 2017
- 7. Minimal change disease treatment Induction of remission No CI to CST Corticosteroids 4-16 weeks A gradual glucocorticoid taper should start 2 weeks after remission (i.e. complete the dose that get the patient in remission for 2 weeks) The gradual tapper on 6 months (24 weeks) CI for CST • Cyclophosphamide • Calcineurin inhibitors • Mycophenolate mofetil/ sodium mycophenolate + reduced-dose glucocorticoids • Rituximab? IR Treated similarly to the initial presentation, with lower and less prolonged doses of glucocorticoids. FR, SD remission is induced with glucocorticoids No previous Cyclophos- phamide No patient preference Cyclophosphamide Previous cyclophosphamide Patient wishes to avoid cyclophosphamide • Rituximab • Calcineurin inhibitors • Mycophenolate mofetil/ sodium mycophenolate SR Treated similar to glucocorticoid- refractory FSGS + Revaluate for other cause (FSGS) ± biopsy
- 8. MCD IN ADULTS - TREATMENT
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- 14. but less certain for patients who do not respond.