Focal segmental glomerulosclerosis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Focal segmental glomerulosclerosis is caused by an injury to podocytes in the renal glomeruli.
May be primary (idiopathic) due to an unknown cause or secondary to an underlying condition, such as HIV, medications, or a maladaptive response to decreased renal mass.
May be asymptomatic or present with nephrotic syndrome.
First-line therapy in primary focal segmental glomerulosclerosis with nephrotic-range proteinuria is corticosteroid therapy. The secondary form requires treatment of the underlying cause.
Corticosteroid-dependent and corticosteroid-resistant patients require treatment with other immunosuppressants such as a calcineurin inhibitor.

Quick Reference

History & Exam
- Key Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Characteristic features of focal segmental glomerulosclerosis (FSGS) lesions
Facial edema in a child with nephrotic syndrome
Muehrcke lines in a patient with hypoalbuminemia due to nephrotic syndrome
Xanthomata in a patient with severe hyperlipidemia
Light microscopy of renal biopsy showing typical lesions of focal segmental glomerulosclerosis

Citations

Key Articles

Rosenberg AZ, Kopp JB. Focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2017 Mar 7;12(3):502-17.[Abstract][Full Text]
Beaudreuil S, Lorenzo HK, Elias M, et al. Optimal management of primary focal segmental glomerulosclerosis in adults. Int J Nephrol Renovasc Dis. 2017 May 10;10:97-107.[Abstract][Full Text]
Kidney Disease: Improving Global Outcomes. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Oct 2021 [internet publication].[Full Text]

Referenced Articles

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37. Ren H, Shen P, Li X, et al. Tacrolimus versus cyclophosphamide in steroid-dependent or steroid-resistant focal segmental glomerulosclerosis: a randomized controlled trial. Am J Nephrol. 2013;37(1):84-90.[Abstract]
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