The main cause of minimal change ds is
Etiology of minimal change ds is unknown. Electron microscopy reveals the primary injury to the visceral epithelial cells, which may be caused by:- A) immunological mechanism: Lack of immune deposits in the glomerulus exclude the possibility of immune complex mechanism. But several features suggest immunological mechanisms like 1.H/o respiratory infection or routine prophylactic immunization 2.dramatic response to coicosteroids 3.asscoiated with allergies or atopic disorder 4.increased incidence in Hodgkin&;s lymphoma patient s. Immune dysfn _>increased cytokine production_these damage visceral epithelial cells _ increase glomerular permeability _proteinuria B) Non-immunological mechanism:- 1.mutations in structural proteins -nephrin(found in congenital nephrotic syndrome -Finnish type)& podocin. MCD is accompanied by loss of glomerular polyanions on GBM. Defects in charge barrier allows selective proteinuria-albumins. Ref: General and systemic pathology -Ramadas Nayak-First edition -page no: 521
Increase in pore size
Loss of negative charge on membrane
Loss of cells
Decreased circulation
Renal physiology