## Minimal Change Disease (MCD) — Epidemiology **Key Point:** Minimal change disease is the most common cause of nephrotic syndrome in children, accounting for 85–90% of cases in the pediatric population. ### Age-Related Prevalence - **Children (age 2–6 years):** 85–90% of nephrotic syndrome cases - **Adolescents:** Still >80% of cases - **Adults:** Only 10–15% of nephrotic syndrome; membranous nephropathy becomes more common ### Why MCD Dominates in Children 1. Selective proteinuria (mainly albumin) 2. Excellent response to corticosteroids (>90% remission rate) 3. Preserved renal function at presentation 4. No immune complex deposition on immunofluorescence **High-Yield:** The dramatic shift from MCD (children) to membranous nephropathy (adults) is a classic NEET PG discriminator. Always anchor age to the most likely glomerulonephritis. **Clinical Pearl:** A child presenting with nephrotic syndrome and normal renal function should be presumed to have MCD until proven otherwise — kidney biopsy is often deferred if clinical features are typical and response to steroids is monitored. [cite:Robbins 10e Ch 20]
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