Watts A, Keller K, Lerner G, et al. - A subset of adults and children with minimal change disease was found to have nephrin autoantibodies, this observation aligns with published animal studies and further backs an autoimmune etiology. A new molecular classification of nephrin autoantibody minimal change disease was introduced.

• This study was conducted to test the hypothesis that nephrin autoantibodies may exist in patients suffering from minimal change disease.

• Analysis of two independent patient cohorts revealed presence of circulating nephrin autoantibodies during active disease in a subset of patients with minimal change disease.

• Significant reduction or absence of these autoantibodies was evident during treatment response.

• Experts correlated the existence of these autoantibodies with podocyte-associated punctate IgG in renal biopsies from their institutions.

• A patient with steroid-dependent childhood minimal change disease that progressed to end-stage kidney disease was also studied; a massive recurrence of proteinuria after transplantation was related to high pretransplant circulating nephrin autoantibodies in this patient (female).