Minimal change disease epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  ; Vamsikrishna Gunnam M.B.B.S[2]

Overview

Minimal change disease (MCD) is considered a disease of childhood. It is responsible for up to 70-90% of nephrotic syndrome in patients less than 10 years of age, and up to 50% of older children. Among children, several studies have shown a male predominance with approximately 2:1 male to female ratio.

Epidemiology and Demographics

Incidence

  • The incidence of Minimal change disease (MCD) is approximately 2-7 per 100,000 individuals worldwide.[1][2]

Prevalence

  • The prevalence of Minimal change disease (MCD) is not known.[3]
  • The prevalence of Minimal change disease (MCD) is approximately 10–50 cases per 100,000 individuals worldwide.[4]

Age

  • Minimal change disease (MCD) is considered a disease of childhood.
  • It is responsible for up to 70-90% of nephrotic syndrome in patients less than 10 years of age, and up to 50% of older children.[5][6][7]
  • MCD is much less common in the adult population. Nonetheless, it still accounts for 10-15% of nephrotic syndromes in adults.[8][7]

Gender

  • Among children, several studies have shown a male predominance with approximately 2:1 male to female ratio.[9] [10]
  • However, gender differences in pediatric and adult MCD have not been consistent throughout the literature.
  • In one study that recruited 95 adult patients with MCD over a 15-year period, results showed that 80% of subjects are white with a slight female predominance (60%).[9]
  • Among adults, the median age for presentation is approximately 30-40 years.[11]

Geographical Distribution

  • MCD is more common in Asia (approximately 2:1) than it is in North America or Europe.[12] [13]
  • It has been reported to be as rare as 1 case per million in USA.[14][15]
  • The reason behind such discrepancy is unknown; but it is believed to be due to variations in routine work-up procedures and diagnostic clinical practices.

References

  1. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  2. Eddy, Allison A; Symons, Jordan M (2003). "Nephrotic syndrome in childhood". The Lancet. 362 (9384): 629–639. doi:10.1016/S0140-6736(03)14184-0. ISSN 0140-6736.
  3. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  4. Eddy, Allison A; Symons, Jordan M (2003). "Nephrotic syndrome in childhood". The Lancet. 362 (9384): 629–639. doi:10.1016/S0140-6736(03)14184-0. ISSN 0140-6736.
  5. Cho MH, Hong EH, Lee TH, Ko CW (2007). "Pathophysiology of minimal change nephrotic syndrome and focal segmental glomerulosclerosis". Nephrology (Carlton). 12 Suppl 3: S11–4. doi:10.1111/j.1440-1797.2007.00875.x. PMID 17995521.
  6. Cameron JS (1996). "Nephrotic syndrome in the elderly". Semin Nephrol. 16 (4): 319–29. PMID 8829270.
  7. 7.0 7.1 Cameron JS, Turner DR, Ogg CS, Sharpstone P, Brown CB (1974). "The nephrotic syndrome in adults with 'minimal change' glomerular lesions". Q J Med. 43 (171): 461–88. PMID 4422336.
  8. Zech P, Colon S, Pointet P, Deteix P, Labeeuw M, Leitienne P (1982). "The nephrotic syndrome in adults aged over 60: etiology, evolution and treatment of 76 cases". Clin Nephrol. 17 (5): 232–6. PMID 7094440.
  9. 9.0 9.1 Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G; et al. (2007). "Adult minimal-change disease: clinical characteristics, treatment, and outcomes". Clin J Am Soc Nephrol. 2 (3): 445–53. doi:10.2215/CJN.03531006. PMID 17699450.
  10. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  11. Huang JJ, Hsu SC, Chen FF, Sung JM, Tseng CC, Wang MC (2001). "Adult-onset minimal change disease among Taiwanese: clinical features, therapeutic response, and prognosis". Am J Nephrol. 21 (1): 28–34. doi:46215 Check |doi= value (help). PMID 11275629.
  12. Feehally J, Kendell NP, Swift PG, Walls J (1985). "High incidence of minimal change nephrotic syndrome in Asians". Arch Dis Child. 60 (11): 1018–20. PMC 1777627. PMID 4073934.
  13. Vivarelli, Marina; Massella, Laura; Ruggiero, Barbara; Emma, Francesco (2017). "Minimal Change Disease". Clinical Journal of the American Society of Nephrology. 12 (2): 332–345. doi:10.2215/CJN.05000516. ISSN 1555-9041.
  14. Saha TC, Singh H (2006). "Minimal change disease: a review". South Med J. 99 (11): 1264–70. PMID 17195422.
  15. Sharples PM, Poulton J, White RH (1985). "Steroid responsive nephrotic syndrome is more common in Asians". Arch Dis Child. 60 (11): 1014–7. PMC 1777619. PMID 4073933.

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