The hallmark of minimal change disease in children is acute-onset proteinuria that progresses into nephrotic syndrome. Fatigue and subsequent edema develops with symptoms of periorbital edema and weight gain. Children are less likely to present with other clinical features, such as hypertension, renal failure, or hematuria. In contrast, adults are more likely to present with hypertension in approximately 40% of cases, and hematuria in approximately 30% of cases. A reduced estimated glomerular filtration rate (eGFR) at presentation is also not uncommon. Finally, upper respiratory tract infection, such as pneumonia in an otherwise healthy individual, may be the first sign of nephrotic syndrome in minimal change disease.

The hallmark of minimal change disease is proteinuria.^[1]

Patients with minimal change disease may have a positive history of:^[2][3][4]

• Upper respiratory tract infection.
• Infections such as
  • Sepsis
  • Pneumonia
  • Peritonitis
• Diarrhea

Common symptoms of minimal change disease include:^[5][6][7][8]

• Fatigue
• Edema: periorbital edema, weight gain^[9]
• Hypertension
• Hematuria^[9][10]
• Symptoms of infections, such as pneumonia^[9]
• Irritability
• Headache

Less common symptoms of minimal change disease include^[11][12][13]

• Thromboembolism^[14]
• Cardiovascular disease
• Thyroid dysfunction
• Hypocalcemia
• Hypovitaminosis D^[10]