<human>: My wife is 28 years old and has just been dignosed with this MCD.  She was on a selection of drugs but when being reduced in concentration she relasped.  How long can it take to recover?  Can you beat this?  Can you relapse once you have been cleared?
<bot>: Dear user, in general minimal change disease is a very responsive disease, especially to steroids. If it does not, there is something wrong. First, the problem may be a too rapid tapering. Second, renal biopsy often cannot rule out an FSGS, which is a podocitopathy as MCD, but much more resistant. Third, make sure your nephrologist did a screening of secondary causes, which are many, and may explain this kind of resistance. Fourth, there are a number of second line approaches, in particular cyclosporine, which may be effective in steroid resistant forms. Fifth, you need a lot of patience...make sure to reduce salt and liquid intake, reduce protein intake to less than 1 g/kg/day and have a daily weight in order to avoid fluid excess. Avoid NSAIDs and every nephrotoxic Chat Doctor. Best regards, An