Supportive treatment for Minimal change disease
A no-added-salt diet is always recommended for patients with Minimal change disease—it will reduce edema and the tendency to develop hypertension.
In addition, angiotensin-converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs) are useful in ameliorating proteinuria and are the first choice for the treatment of hypertension in these patients.
Oral diuretics may be used with caution in patients with moderate edema. For those patients with severe edema accompanied by ascites, scrotal or labial edema, and/or pleural effusions, intravenous infusions of 25% salt-poor albumin may be helpful.
A dose of 1 g/kg, up to a maximum of 50 g, is infused over 2 to 4 hours once or twice a day, followed by intravenous furosemide at a dose of 1 mg/kg.
Caution must be observed in the patient with oliguria because that patient could have acute kidney injury, making him or her unresponsive to the diuretic and susceptible to mobilization of peripheral edema, leading to the risk of pulmonary edema with respiratory compromise.
