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A previously healthy, Vietnamese, 44-year-old woman named Victoria complained of recent fatigue and swelling of her feet and ankles. She also noted puffy eyes. Physical examination revealed an afebrile woman with lower extremity edema extending to the knee, periorbital edema, and a small amount of ascites.
 

Urinalysis: protein 4+
glucose neg
blood neg
bilirubin neg
Micro: rare RBCs, no WBCs, many oval fat bodies

Creatinine

0.8 mg/dL

BUN

18 mg/dL

Albumin

2.8 gm/dL

Hematocrit

40%

Liver function tests

normal

Triglycerides

400 mg/dL

Cholesterol

375 mg/dL

24-hr urine protein

11.2 gm/24 hr

Drug history was negative. ANA, HIV, and hepatitis serologies were negative at this time.

The patient developed right flank pain the following day. Ultrasound examination revealed renal vein thrombosis. A renal biopsy was performed.

 

What is the pathogenesis of minimal change disease or MCD?
Explain how patients with this pattern differ from patients with MCD in terms of response to steroids, the progression of renal disease, hematuria, hypertension, and selectivity of proteinuria.
SCIENCE
HEALTH SCIENCE
NURSING
NUR 3056

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