A Retrospective Analysis On The Treatment Of Minimal Change Disease

【Objective】 To study the therapeutic effects of the glucocorticoid therapy on minimalchange disease (MCD) and related factors that may affect its recurrence, so as to providebasic therapy for the following treatment of patients with MCD glucocorticoid therapyafter remission.【Methods】Aretrospective analysis was performed on MCD patients hospitalized in theNephrology department of Shanghai Jiaotong University Affiliated FirstPeople’s Hospital from June2010to September2013. After screening, a total of65patients were selected as cases. According to the results of glucocorticoid treatment andnephritic syndrome relapse, all patients were divided into three groups including therecurrence observed group (n=23), recurrence not observed group (n=34) and the othercases else (n=8). For the patients without contraindication, glucocorticoid therapy wasprior; for the infrequent relapses, repeat courses of glucocorticoid therapy should beapplied as in the first episode of MCD; but for the frequently relapsers andglucocorticoid-dependent patients, glucocorticoid therapy combined with CTX, CsA orTAC treatment was granted according to their actual circumstances. The SPSS17.0statistical software was used for the analysis of the patient’s general conditions as well asother clinical or laboratory parameters.【Results】The average age of recurrence group was younger than the group withoutrecurrence observed, the disease duration of recurrence group was longer than thenon-recurrence group, while the diabetes and hypertension rate of recurrence group washigher than the non-recurrence group. All the differences were statistically significant(P<0.05). MCD relapses were well-correlated with patients’ age with statisticallysignificance (P <0.05). There was no significant difference (P>0.05) observed in theprognosis of MCD between TSH normal group and TSH elevated group. The serumalbumin level in TSH elevated group before or after treatment were both lower than in the TSH normal group, the difference was also statistically significant (P<0.05). After thetherapy with three cytotoxic drugs, the differences of clinical and laboratory indicesbetween each group were not statistically significant (P>0.05).【Conclusion】Relapses were well-correlated with patients’ age, and younger patientshad a higher risk of relapse. The serum albumin level in TSH elevated patients before orafter treatment were both lower than in the TSH normals, while the thyroid hormonelevel was not correlated to the replaces in MCD patients. There were no significantdifferences in the effects of cytotoxic drugs’ therapies in MCD, but we should carefullyevaluate the benefits and risks before treatment.