Minimal change disease and focal segmental glomerulosclerosis in adults: rituximab

What are minimal change disease and focal segmental glomerulosclerosis?

Minimal change disease and focal segmental glomerulosclerosis are conditions that can affect the kidneys. They are a form of glomerular disease, with damage to the tiny structures within the kidneys (called the glomeruli) which filter the blood to make urine. Damage to the glomeruli can affect how well the kidneys work. Protein from the blood can leak into the urine. This can cause swelling of the feet and legs, and sometimes rapid build-up of fluid in other parts of the body. Other complications include high cholesterol and blood clots. Medicines are prescribed to manage these complications.

In minimal change disease, treatment aims to control the condition and stop further damage to the kidneys. In the first instance, steroids are given at high doses. These are reduced slowly and then stopped in many cases. In some cases, the condition comes back when the dose of steroid is reduced. This is called steroid-dependent minimal change disease. Sometimes larger doses of steroids are needed to control the condition or steroids don't seem to work very well at all. This is known as steroid-resistant minimal change disease. In these situations, a specialist doctor may prescribe different medicines with or without the steroids. These other medicines include cyclophosphamide, ciclosporin, tacrolimus, mycophenolate mofetil and rituximab.

In focal segmental glomerulosclerosis, treatment aims to control the condition and slow down the rate of kidney damage. The medicines used for focal segmental glomerulosclerosis are the same as for minimal change disease. As in minimal change disease, focal segmental glomerulosclerosis can be steroid resistant or steroid dependent.