Minimal change disease laboratory findings
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Laboratory findings in minimal change disease include elevated hematocrit, pseudohyponatremia, hypocalcemia, and abnormal lipid panel. Findings of urine analysis include elevated urinary specific gravity, proteinuria that might reach nephrotic range, high urinary protein-creatinine ratio, microscopic hematuria, and lipid-laden cells.
Laboratory Findings
Blood
- Fibrinogen, factors V and VIII, and protein C increases and increased risk of thrombosis due to hypercoagulability.[1][2]
- Elevated hematocrit due to volume contraction.[3]
- Serum electrolytes may show pseudohyponatremia, defined as low serum sodium levels due to elevated serum lipids.
- Hypocalcemia.
- Hypovitaminosis D.
- Normal/elevated serum creatinine.
- Hypoalbuminemia.
- Abnormal lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides) due to[4]
- Decreased activity of lipoprotein lipase.
- Decreased LDL receptor activity.
- Increased urinary loss of HDL and antithrombin III.
- IgG decreased.
- IgA is minimally reduced.[5]
- IgM is increased.
Urine
- 24-hour urinary analysis is indicated in the work-up of minimal change disease.[6][7]
- Elevated urinary specific gravity.
- Proteinuria that might reach nephrotic range.
- High urinary protein-creatinine ratio.
- Microscopic hematuria.
- Lipid-laden cells.
- Gross hematuria.[8]
- Urinary dipstick showing 3+/4+ proteinuria (≥300 mg/dl).[9]
- Urine protein-to-creatinine ratio >200 mg/mmol.
- Urine proteins >3.5 g/d in adults.[10]
- Increased α2-globulin and a reduced γ–globulin fraction.
References
- ↑ Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). “Minimal Change Disease”. Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
- ↑ Kerlin BA, Ayoob R, Smoyer WE (March 2012). “Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic disease”. Clin J Am Soc Nephrol. 7 (3): 513–20. doi:10.2215/CJN.10131011. PMC 3302669. PMID 22344511.
- ↑ Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). “Minimal Change Disease”. Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
- ↑ Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). “Minimal Change Disease”. Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
- ↑ Oberweis BS, Mattoo A, Wu M, Goldfarb DS (2013). “Minimal change disease and IgA deposition: separate entities or common pathophysiology?”. Case Rep Nephrol. 2013: 268401. doi:10.1155/2013/268401. PMC 3914242. PMID 24527245.
- ↑ Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). “Minimal Change Disease”. Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
- ↑ 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.
- ↑ Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). “Minimal Change Disease”. Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
- ↑ Vivarelli M, Massella L, Ruggiero B, Emma F (February 2017). “Minimal Change Disease”. Clin J Am Soc Nephrol. 12 (2): 332–345. doi:10.2215/CJN.05000516. PMC 5293332. PMID 27940460.
- ↑ Waldman M, Crew RJ, Valeri A, Busch J, Stokes B, Markowitz G, D’Agati V, Appel G (May 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.
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