Minimal change disease (also known as MCD, minimal change glomerulopathy, and nil disease, among others) is a disease affecting the kidneys which causes a nephrotic syndrome. Nephrotic syndrome leads to the loss of significant amounts of protein in the urine, which causes the widespread edema (soft tissue swelling) and impaired kidney function commonly experienced by those affected by the disease. It is most common in children and has a peak incidence at 2 to 6 years of age. MCD is responsible for 10–25% of nephrotic syndrome cases in adults. It is also the most common cause of nephrotic syndrome of unclear cause (idiopathic) in children. Signs and symptoms
The clinical signs of minimal change disease are proteinuria (abnormal excretion of proteins, mainly albumin, into the urine), edema (swelling of soft tissues as a consequence of water retention),  weight gain, and hypoalbuminaemia (low serum albumin). These signs are referred to collectively as nephrotic syndrome. The first clinical sign of minimal change disease is usually edema with an associated increase in weight. The swelling may be mild but patients can present with edema in the lower half of the body, periorbital edema, swelling in the scrotal/labial area and anasarca in more severe cases. In older adults, patients may also present with acute kidney injury (20–25% of affected adults) and high blood pressure. Due to the disease process, patients with minimal change disease are also at risk of blood clots and infections.
Naftifine hydrochloride (brand names include Exoderil and Naftin) is an allylamine antifungal drug for the topical treatment of tinea pedis, tinea cruris, and tinea corporis (topical fungal infections). Naftifine has triple action: antifungal, antibacterial, and anti-inflammatory. Its fungistatic activity is believed to be based on inhibition of the squalene-2,3-epoxidase enzyme, which in turn results in the shortage of ergosterol required for the formation of fungal cell membranes. With some fungal species, there is also fungicidal activity from a resulting accumulation of squalenes, leading to damage of the fungal cell membranes, including at the endoplasmatic reticulum. The half-life is approximately 2–3 days. The metabolites are excreted in the urine and feces.Naftifine was invented at the Sandoz Research Institute in Vienna, Austria. It was the first succesful antifungal medication of the allylamine class. Naftifine shows mostly fungicidal activity toward dematophytes and molds, and mostly fungistatic activity toward yeasts. It is also effective as an antibacterial agent in treating pyoderma. Naftifine is almost completely metabolized in the human body, with a half-life of 2–3 days. Its metabolytes do not have antifungal activity, and they are excreted with urine and bile. == References ==