A recent study in Kidney International talks about a possible biomarker that might be useful in distinguishing Minimal Change Disease from FSGS. Urinary excretion of CD80 (also known as B7.1) is elevated in patients with MCD. Urinary CD80 was measured in 17 patients with biopsy-proven MCD and 22 with proven FSGS. A significant increase in urinary CD80, normalized to urinary creatinine, was found in patients with MCD in relapse compared to those in remission or those with FSGS. In seven of eight MCD patients in relapse, CD80 was found in glomeruli by immunohistochemical analysis of their biopsy specimen. No CD80 was found in glomeruli of two patients with FSGS and another MCD patient in remission. Given this finding, the authors side the notion that MCD and FSGS are distinct entities and not a spectrum of the same disease.
I think that perhaps in children they might be a distinct different disease, but perhaps in adults still could be the same disease caught at a later time. Perhaps early on in the disease, you shed CD80 and then it decreases due to focal sclerosis. Lets see how the Glomerular world embraces this marker. http://www.ncbi.nlm.nih.gov/pubmed/20485332 http://www.ncbi.nlm.nih.gov/pubmed/19056875
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