Hi Dr. I am hoping to get your opinion on treating Minimal Change Disease in adults. I was diagnosed 7 yrs ago and went on 80mg x 8wks of Prednisone and tapered off every 10 days by 2.5mg. It was a long treatment and my symptoms reversed and I was able to be in remission for 7yrs. I’m currently having a relapse with CREATININE 5135 MG/G CREAT ALBUMIN 3.5 G/DL (normal range). First time my albumin was off and I had extensive edema. This time I do not have edema but I’m spilling protein. My current doctor wants to wait 2 weeks before treating me to see if my levels get better on their own. My question is 1, do I really need to start at 80mg? How would you recommend treatment? I’m not sure if you can answer these questions but would be of great help if you could so I’d have an alternate opinion. Thank you for your time.

I am unable to recommend medical treatment without performing a complete history and physical examination. If this is a relapse of your original disease, treatment with your original therapy is most often recommended. If it worked once, it will likely work again. Prednisone is the standard treatment for Minimal Change Disease (MCD). I am not sure I can interpret the urine protein findings that you quote. This is most often quoted as a urine albumin to creatinine ratio (ACR) and it is expressed as milligrams per gram of creatinine (mg/g). The normal range for the ACR is less than 30 mg/g of creatinine.

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