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Focal Segmental Glomerulosclerosis
FGS

Images

WIKIDATA, CC BY-SA 3.0
WIKIDATA, CC BY-SA 3.0

Presentation

In the current study, 63% of patients presented haematuria and 40% presented hypertension. El-Refaey et al. [14] showed that haematuria was present in 24% of cases and 21% patients presented hypertension. [latunisiemedicale.com]

Depending on the cause it is broadly classified as: Primary, when no underlying cause is found; usually presents as nephrotic syndrome Secondary, when an underlying cause is identified; usually presents with kidney failure and proteinuria. [en.wikipedia.org]

Predicting renal survival in primary focal glomerulosclerosis from the time of presentation. [ncbi.nlm.nih.gov]

The average age at presentation of FSGS patients was 24.28 ± 19.3 years, ranging from 2 to 74 years. There were 38 females (32.76%) and 78 males (67.27%). The most common age-group at presentation was 11-30 years. [sjkdt.org]

Workup

Figure 2: Pre-transplant workup and management of patients with FSGS [3]. [medcraveonline.com]

Urine

  • Pyuria

    Drug-induced Interstitial Nephritis Analgesic nephropathy Acute Drug-Induced Interstitial Nephritis Acute renal failure in ~50% of patients May be clinically evident only as progressive increase in serum Cr Urine findings - hematuria, mild proteinuria, pyuria [sites.google.com]

Treatment

Treatment MCD is highly responsive to corticosteroids, which is first-line treatment. Almost all children respond within 2 months after initiating steroid treatment, whereas up to 95% of adults respond within 4 months. [renalandurologynews.com]

The goal of treatment is to control the symptoms of nephrotic syndrome and prevent chronic kidney failure. [nlm.nih.gov]

Product Code: 64100 Focal Segmental Glomerulosclerosis Treatment Market Overview The focal segmental glomerulosclerosis (FSGS) treatment market is expected to register a growth rate of about 7.5% over the forecast period, 2018-2023. [gii.co.jp]

Steroid dependency was defined as at least two relapses during alternate-day treatment with prednisone or within 14 days after stopping this treatment. [latunisiemedicale.com]

Currently, optimal treatment remains controversial. We propose a management protocol that includes treatment with Plasma Exchange (PEX) and Rituximab (RTX). [atcmeetingabstracts.com]

Prognosis

[…] glomerulonephritis, in which the male:female ratio is 1.2:1. 3) The prognosis for females is no better than for males. 4) The severity of proteinuria at the time of biopsy has no influence on the prognosis. 5) The prognosis is particularly poor in cases [ncbi.nlm.nih.gov]

The clinical course, prognosis and outcome of FSGS are heterogeneous. [sjkdt.org]

Prognosis is extremely variable and depends on the amount of proteinuria, the level of plasma creatinine, the morphological subtype, the degree of renal fibrosis, and the response to therapy. [bestpractice.bmj.com]

Etiology

There is a complex interplay between etiologic and pathogenic factors, progression factors and intervention in the phenotypic expression of FSGS. [ncbi.nlm.nih.gov]

[…] focal and segmental hyalinization of the glomeruli, often with immunostaining showing IgM and complement (C3) deposits in a nodular and coarse granular pattern. [4] In HIV-associated FSGS, an ultrasound generally reveals large echogenic kidneys. [3] Etiology [physio-pedia.com]

Epidemiology

Nevertheless, the available data suggest that large epidemiological case-control studies to examine the association between NPHS2 variants and nephrotic syndrome are warranted. [ncbi.nlm.nih.gov]

Focal segmental glomerulosclerosis – epidemiology aspects in chil- dren and adults. Pediatr Nephrol. 2007; 22 (2): 183-6. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC1764601/ DOI: 10.1007/s00467-006-0370-5 10. [revistas.unilibre.edu.co]

Focal segmental glomerulosclerosis – epidemiology aspects in children and adults. [revistasojs.unilibrecali.edu.co]

Dr Franceschini is supported by the Department of Epidemiology, University of North Carolina School of Public Health. [doi.org]

Renal asociated with human inmunodeficiency virus infections: epidemiology, clinical course and managements. Clin Infect Dis. 2001;33(1):115-9. https://dx.doi.org/10.1086/320893. [ Links ] 9. [scielo.org.co]

Pathophysiology

The primary pathophysiologic process in FSGS is an injury inherent within or directed to podocytes. [emedicine.com]

Prevention

The goal of treatment is to control the symptoms of nephrotic syndrome and prevent chronic kidney failure. [nlm.nih.gov]

[…] study is to assess the efficacy of the bleselumab regimen (basiliximab induction, tacrolimus, steroids and bleselumab) compared with the Standard of Care (SOC) regimen (basiliximab induction, tacrolimus, steroids and mycophenolate mofetil [MMF]) in the prevention [clinicaltrials.ucsf.edu]

We hope that finding the genetic causes of FSGS will eventually lead to prevention and better treatment. [dmpi.duke.edu]

Recent findings on podocin genomics, the permeability factor and CD80 expression may ultimately lead to a better understanding of recurrent FSGS as well as a more effective approach to its prevention and treatment. [ncbi.nlm.nih.gov]

Nonspecific Treatment [3] “Treatment goals include maintenance of adequate nutrition, minimization or elimination of proteinuria, and prevention of complications resulting from edema. [physio-pedia.com]

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