Minimal Change Glomerular Disease in Malaysian Adults and use of Alternate Day Steroid Therapy

One hundred and forty-eight patients over the age of 12 yearsseen from July 1972 through December 1980 were accepted forthis review of minimal change glomemlar disease (MCGD). Thediagnosis was based on a typical clinical presentation, andrenal biopsy findings MCGD forms 43.5 per cent of our patients with idiopathic nephroticsyndrome. The patients were predominantly young adults (82 percent) and the onset of nephrotic syndrome (NS) occurred belowthe age of 30 years. Most patients had severe oedema and hypoalbuminaemia.Few patients recovered spontaneously. One hundred and thirty patients were given long-term alternate-daysteroid (LASt) therapy. Four had cyclophosphamide alone, 21patients had cyclophosphamide after a trial of LASt Eighty-fourpatients (62.7 per cent) were initial res ponders: 17 of theseafter cyclophosphamide, 26 (19.4 per cent) were initial non-responders:five cyclophosphamide, 19 were late responders. Nine patientswere partial responders, six were non-responders and one wentinto renal failure. Forty-one patients defaulted, emigratedor were seen only locally at the time of study. Ninety-ninepatients were followed for three to 102 months (mean 23.3 months).Thirty-seven patients were followed for 36 to 102 months. Relapseswere infrequent but occurred as late as 60 months.