A report describes a case of a 30-year-old Indian female who presented with generalized swelling all over the body for one week. The swelling started in the periorbital area and progressed gradually, leading to generalized anasarca. She had a history of intermittent usage of NSAIDs for the last five years for body aches and muscle soreness. Her vitals were within normal limits, and her physical examination showed periorbital and pedal edema (3+). 

Laboratory parameters revealed:

• serum creatinine= 2.80 mg/dl,
• BUN = 79.2 mg/dl,
• serum albumin = 2.04 gm%,
• total protein = 4.47 gm%,
• total cholesterol = 198.6 mg/dl,
• serum triglycerides = 425 mg/dL.
• Twenty-four-hour urine protein assay = 6.93 grams. 

Her HIV, hepatitis B, and hepatitis C profile were negative. 

Chest x-ray revealed bilateral pleural effusion.

Abdominal ultrasound revealed an edematous gallbladder with moderate ascites. 

She was given diuretics and intravenous albumin to treat fluid overload, regressing her edema initially in the first week but it later recurred rapidly. Hence she underwent a renal biopsy. 

The light microscopic histopathology revealed luminal dilatation of tubules, epithelial simplification with a few tubules displaying luminal granular material with normal glomeruli without any basement membrane thickening, segmental sclerosis, any proliferative lesion or interstitial changes. Immunofluorescence showed seven glomeruli, negative for IgG, IgA, IgM, Kappa, Lambda, C3, and C1q, without extraglomerular staining. 

She received the diagnosis of acute tubular injury with minimal change of disease. 

The patient was treated with prednisolone 1mg/kg body weight, causing edema regression in 2 weeks. Her serum creatinine dropped to 1.10 mg/dL, and BUN, serum albumin, and protein levels also showed satisfactory improvement. 

She showed no further relapses in follow-up outpatient visits for up to 4 months of observation.

Kaur P. Acute Kidney Injury in Minimal Change Disease in Young Female: A Case Report. MRCS. 2022;7(8): 000-001.