Minimal Change Disease and Hematuria

Classic Presentation

• The American Academy of Pediatrics and Nephrology societies suggest that minimal change disease is characterized by nephrotic syndrome with massive proteinuria, edema, hypoalbuminemia, and hyperlipidemia, without significant hematuria 1, 2

Diagnostic Considerations

• The presence of hematuria in a patient with suspected minimal change disease warrants a complete hematuria workup, including assessment for dysmorphic red blood cells, red cell casts, proteinuria quantification, and consideration of other causes 4

Distinguishing Glomerular vs Non-Glomerular Hematuria

• The assessment for dysmorphic RBCs or red cell casts is crucial, as these findings suggest glomerular bleeding and warrant nephrology evaluation, potentially indicating a different glomerular disease process 3