Focal segmental glomerulosclerosis

Focal segmental glomerulosclerosis
Other namesfocal glomerular sclerosis,[1] focal nodular glomerulosclerosis[1]
Light micrograph of focal segmental glomerulosclerosis, hilar variant. Kidney biopsy. PAS stain.
SpecialtyNephrology Edit this on Wikidata

Focal segmental glomerulosclerosis (FSGS) is a histopathologic finding of scarring (sclerosis) of glomeruli and damage to renal podocytes.[2][3] This process damages the filtration function of the kidney, resulting in protein presence in the urine due to protein loss.[3] FSGS is a leading cause of excess protein loss—nephrotic syndrome—in children and adults in the US.[4] Signs and symptoms include proteinuria and edema.[2][5] Kidney failure is a common long-term complication of the disease.[5][6] FSGS can be classified as primary, secondary, or genetic, depending on whether a particular toxic or pathologic stressor or genetic predisposition can be identified as the cause.[7][8][9] Diagnosis is established by renal biopsy,[2][10] and treatment consists of glucocorticoids and other immune-modulatory drugs.[11] Response to therapy is variable, with a significant portion of patients progressing to end-stage kidney failure.[5] An American epidemiological study 20 years ago demonstrated that FSGS is estimated to occur in 7 persons per million, with cisgender male African-Americans at higher risk.[12][13][7]

  1. ^ a b "focal segmental glomerulosclerosis" at Dorland's Medical Dictionary.
  2. ^ a b c Rosenberg AZ, Kopp JB (March 2017). "Focal Segmental Glomerulosclerosis". Clin J Am Soc Nephrol. 12 (3): 502–517. doi:10.2215/CJN.05960616. PMC 5338705. PMID 28242845.
  3. ^ a b D'Agati V (October 1994). "The many masks of focal segmental glomerulosclerosis". Kidney Int. 46 (4): 1223–41. doi:10.1038/ki.1994.388. PMID 7861720.
  4. ^ Kitiyakara C, Eggers P, Kopp JB (November 2004). "Twenty-one-year trend in ESRD due to focal segmental glomerulosclerosis in the United States". Am J Kidney Dis. 44 (5): 815–25. doi:10.1016/S0272-6386(04)01081-9. PMID 15492947.
  5. ^ a b c Rydel JJ, Korbet SM, Borok RZ, Schwartz MM (April 1995). "Focal segmental glomerular sclerosis in adults: presentation, course, and response to treatment". Am J Kidney Dis. 25 (4): 534–42. doi:10.1016/0272-6386(95)90120-5. PMID 7702047.
  6. ^ Korbet SM, Schwartz MM, Lewis EJ (June 1994). "Primary focal segmental glomerulosclerosis: clinical course and response to therapy". Am J Kidney Dis. 23 (6): 773–83. doi:10.1016/s0272-6386(12)80128-4. PMID 8203357.
  7. ^ a b "Focal segmental glomerulosclerosis (FSGS)". www.kidneyfund.org. 2021-10-28. Retrieved 2023-11-14.
  8. ^ Haas M, Meehan SM, Karrison TG, Spargo BH (November 1997). "Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976–1979 and 1995–1997". Am J Kidney Dis. 30 (5): 621–31. doi:10.1016/s0272-6386(97)90485-6. PMID 9370176.
  9. ^ Cite error: The named reference Fogo15 was invoked but never defined (see the help page).
  10. ^ Kiffel J, Rahimzada Y, Trachtman H (September 2011). "Focal segmental glomerulosclerosis and chronic kidney disease in pediatric patients". Adv Chronic Kidney Dis. 18 (5): 332–8. doi:10.1053/j.ackd.2011.03.005. PMC 3709971. PMID 21896374.
  11. ^ Campbell KN, Tumlin JA (2018). "Protecting Podocytes: A Key Target for Therapy of Focal Segmental Glomerulosclerosis". Am J Nephrol. 47 (Suppl 1): 14–29. doi:10.1159/000481634. PMC 6589822. PMID 29852493.
  12. ^ Tucker JK (February 2002). "Focal segmental glomerulosclerosis in African Americans". Am J Med Sci. 323 (2): 90–3. doi:10.1097/00000441-200202000-00006. PMID 11863085.
  13. ^ Kitiyakara C, Kopp JB, Eggers P (March 2003). "Trends in the epidemiology of focal segmental glomerulosclerosis". Semin Nephrol. 23 (2): 172–82. doi:10.1053/snep.2003.50025. PMID 12704577.