Abstract: FR-PO0987
Minimal Change Disease Presenting as Severe Nephrotic Syndrome During Pregnancy
Session Information
- Women's Health and Kidney Diseases
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2100 Women's Health and Kidney Diseases
Authors
- Baloch, Kanwal Mir, The University of New Mexico, Albuquerque, New Mexico, United States
- Garcia, Pablo, The University of New Mexico, Albuquerque, New Mexico, United States
- Abdali, Mohamed, The University of New Mexico, Albuquerque, New Mexico, United States
- Jayeola, Olakunle A., The University of New Mexico, Albuquerque, New Mexico, United States
Introduction
Nephrotic syndrome during pregnancy is uncommon and may mimic preeclampsia, making diagnosis challenging. Minimal change disease is a rare cause that may present with severe edema and metabolic complications. We present a case of biopsy-proven MCD during pregnancy notable for exceptionally heavy proteinuria and a rapid steroid response, highlighting the value of renal biopsy in guiding management
Case Description
30-year-old woman at 23 weeks gestation presented with acute periorbital and lower extremity edema, frothy urine, and dyspnea. Blood pressure remained normal throughout stay. Initial evaluation revealed nephrotic-range proteinuria with a urine protein-to-creatinine ratio of 30 g/g and 24-hr urine protein of 51.4 g/day. Laboratory studies demonstrated severe hypoalbuminemia (1.0 g/dL), preserved kidney function (creatinine 0.51 mg/dL), microscopic hematuria, and hyperlipidemia. Given the severity of proteinuria, normotension, and need to exclude other glomerular etiologies, kidney biopsy was performed. Histopathology showed minimal change disease with mild interstitial fibrosis and tubular atrophy. Prednisone 60 mg daily was initiated with a rapid response; the UPCR decreased from 15 g/g to 0.4 g/g within 5 days. Given the elevated thrombotic risk with severe nephrotic syndrome in pregnancy, prophylactic enoxaparin was started. She was discharged on a steroid taper with close nephrology and MFM follow-up
Discussion
MCD is a rare but highly steroid-responsive cause of nephrotic syndrome during pregnancy. Distinguishing primary nephrotic syndrome from atypical preeclampsia is essential in normotensive pregnant patients with heavy proteinuria, as management differs significantly. This case underscores the role of kidney biopsy during pregnancy when etiology is uncertain, enabling timely initiation of corticosteroid therapy. Early diagnosis and treatment are critical to reducing maternal complications, including thromboembolic events, and optimizing fetal outcomes
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