We describe 40 adults with idiopathic minimal-change glomerulopathy. They consisted of 27 females and 13 males, mean age 40.7 ± (SD) 19.8 years (range 15–78 years). Twenty patients were < 40 years of age at presentation. They presented with significantly ( p < 0.05) lower serum creatinine (0.9 ± 0.2 vs. 1.3 ± 0.5 mg/dl) and serum albumin (1.9 ± 0.8 vs. 2.4 ± 0.7 g/dl) levels than patients > 40 years. Only 7 patients (18%) presented with a decrease in renal function (serum creatinine > 1.3 mg/dl). All patients had nephrotic-range proteinuria at the time of presentation or biopsy. There was no significant difference in presenting proteinuria (8.7 ± 5.7 g/24 h) or length of follow-up (mean 63.5, range 4–176 months) between the two age groups. Microscopic hematuria and hypertension were each present in 21 % of the patients. Thirty-four patients received therapy with prednisone. A complete remission was obtained in 91 % of the patients treated with prednisone. The response occurred within 16 weeks in 77% of the patients. The response to prednisone therapy was similar for patients < 40 years when compared to those > 40 years, with a complete remission being obtained in 88 and 94%, respectively. The rate of response, however, differed significantly with 73% of patients < 40 years versus 32% of patients > 40 years achieving a complete remission by 8 weeks. Twenty patients initially responding to prednisone therapy (64.5%) relapsed. A relapse occurred within 3 months of attaining a complete remission in 70% of the patients. No difference was recognized between patients < 40 or > 40 years with respect to initial relapse time or total relapses. Eight patients (26%) were steroid dependent. A spontaneous complete remission occurred in 2 patients. At last follow-up, 29 patients (72.5%) were in complete remission, 3 patients were in a partial remission (7.5%), and 8 patients (20%) were nephrotic. Our experience shows that adults with minimal-change glomerulopathy have a clinical presentation and course similar to that of children with the same lesion. A major difference was that the rate of response in our patients was slower than that reported in children. Once in remission, relapse rate and prognosis of our adults mirrored that of the childhood experience with minimal-change glomerulopathy.

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