Lee et al reported factors associated with relapse in adults with minimal change disease (MCD) and the nephrotic syndrome. These can help to identify a patient who may benefit from more aggressive management. The authors are from Seoul National University and Dongguk University in South Korea.
Patient selection: minimal change disease (MCD) with nephrotic syndrome
Outcome: relapse
Predictors for relapse:
(1) younger age at onset (relapse decreased 24% for each 10-year increase in age)
(2) shorter duration of treatment
Age and relapse:
(1) age < 29 associated with relapse
(2) age > 54 associated with no relapse
(3) between 29 and 54 there was overlap
The mean duration of treatment was 30 weeks. In adults > 6 months of therapy recommended.
Predictors for lower risk of relapse:
(1) therapy with combination cyclophosphamide and corticosteroids (adjusted odds ratio 0.36)
(2) mesangial proliferation (adjusted odds ratio 0.49)
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