Focal Segmental Glomerulosclerosis (FSGS)

Focal segmental glomerulosclerosis (FSGS) is a disease in which scar tissue develops on the parts of the kidneys that filter waste from the blood (glomeruli). This condition can lead to kidney failure if left untreated.

Causes and Risk Factors

The exact cause of FSGS is not fully understood, but it is believed to be related to a combination of genetic and environmental factors. Some possible causes include:

• Genetic mutations that affect the functioning of the glomeruli
• Infections such as HIV or parvovirus B19
• Certain medications, such as heroin or pamidronate
• Obesity and related conditions, such as high blood pressure and diabetes
• Family history of kidney disease

Symptoms

The symptoms of FSGS can vary depending on the severity of the condition. Common symptoms include:

• Nephrotic syndrome, characterized by excessive loss of protein in the urine (proteinuria), low levels of albumin in the blood (hypoalbuminemia), and swelling (edema)
• Hematuria (blood in the urine)
• High blood pressure
• Fatigue
• Weight gain due to fluid retention

Diagnosis

FSGS is typically diagnosed through a combination of physical examination, medical history, laboratory tests, and kidney biopsy. The following tests may be used:

• Urinalysis to check for proteinuria and hematuria
• Blood tests to evaluate kidney function and albumin levels
• Imaging studies such as ultrasound or CT scan to visualize the kidneys
• Kidney biopsy to examine the glomeruli for scarring and other abnormalities

Treatment

The treatment of FSGS depends on the underlying cause and severity of the condition. The following treatments may be used:

• Medications to control blood pressure, reduce proteinuria, and slow disease progression
• Corticosteroids or immunosuppressive medications to reduce inflammation and immune system activity
• Diuretics to manage edema and fluid retention
• Lifestyle modifications such as a low-sodium diet, weight loss, and regular exercise
• Kidney transplantation in cases of end-stage renal disease

Prognosis

The prognosis for FSGS varies depending on the severity of the condition and response to treatment. With proper management, some patients may experience remission or stabilization of their kidney function, while others may progress to end-stage renal disease requiring dialysis or transplantation.