What is 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). Much as a coffee filter keeps coffee grounds in, glomeruli filter the blood, taking out the water-like part which becomes urine and leaving the protein in the blood. When glomeruli become damaged or scarred (sclerosis), proteins begin leaking into the urine (proteinuria). The word "focal" is added because in FSGS, only some of the glomeruli filters become scarred. "Segmental" means that only some sections of the glomerulus becomes scarred, just parts of them.
What Causes FSGS?
FSGS can be caused by a variety of conditions. FSGS includes:
Primary FSGS means no underlying cause is found and it usually presents as Nephrotic Syndrome.
Secondary FSGS means an underlying cause is identified and it usually presents with kidney failure and proteinuria. Some causes of secondary FSGS include:
Kidney defects from birth (dysplasia)
Urine backing up into kidneys (kidney reflux)
Obesity
Obstructive Sleep Apnea
Viruses and blood disorders (such as HIV and sickle cell anemia)
Autoimmune disorders (such as lupus and HSP)
Genetic FSGS is caused by genetic mutations. Familial FSGS can also occur when neither parent has the disease, but each carries one copy of an abnormal gene that can be passed on to the next generation.
What are symptoms of FSGS?
FSGS symptoms include:
Proteinuria-lots of protein leak into urine
Edema-swelling in your body parts especially around the eyes, hands and feet, and abdomen which can lead to sudden weight gain.
High blood pressure sometimes can be hard to treat
High cholesterol in some cases can occur
Low blood albumin levels occur because the kidneys are removing albumin instead of returning it to the blood.
What is the treatment for FSGS?
CEIs and ARBs are nonspecific agents that reduce proteinuria because of their antihypertensive and intrarenal hemodynamic effects of reducing glomerular capillary pressure and resistance. ACEIs and ARBs are effective in reducing protein loss even in normotensive patients. These agents do not eliminate proteinuria completely or reverse the primary glomerular disease process.
Nonspecific treatment goals in patients with nephrotic syndrome include maintenance of adequate nutrition, minimization or elimination of proteinuria, and prevention of complications resulting from edema. Control of hypertension is one of the most important aspects of overall management. Lowering of lipid levels is necessary to reduce cardiovascular risk and to possibly delay the progression of renal disease.
Diuretics: These medications help your body get rid of excess fluid and swelling. These can be used to lower your blood pressure too.
What is the diet of FSGS?
Some diet changes may be necessary, such as reducing salt and protein in your food choices to reduce the load of wastes on the kidneys.
What is the prognosis of FSGS?
Treatment can slow the process of kidney disease. Everyone is different in how they respond to treatment. Some patients with FSGS gradually get worse until they reach kidney failure. In this condition, they need a kidney transplant or dialysis to stay alive. Some patients respond well to treatment and may live with the disease for many years while being monitored for any signs of changes.
