What is the standard initial treatment for Minimal change disease in adults?
Prednisone is also the standard initial therapy for adults with MCD.
Adults with MCD tend to require a longer course of prednisone before remission is attained. The optimal initial prednisone regimen varies somewhat among nephrologists, but typically a single morning dose of 1 mg/kg per day, maximum of 80 mg, is continued for a minimum of 8 weeks.
For patients not in remission at 8 weeks, daily prednisone may be continued for another 2 months until remission is attained.
A gradual taper is then recommended on an every-other-day schedule until the patient is tapered off over many months.
The slow taper is recommended to sustain the remission and to reduce the likelihood of problems with adrenal insufficiency.
