Focal segmental glomerulosclerosis (FSGS) is a kidney disease that often results in end-stage renal failure. A kidney transplant is the best way to treat this failure. The issue with this procedure is that it is unsuccessful about 30% of the time. For a long time, doctors were unable to predict whether the transplanted kidney would fail. Now, Dr. Deepak Nihalani of the Medical University of South Carolina has created a diagnostic technique that gives better predictions of kidney transplant success. These predictions will not only help doctors, but they will remove a lot of the emotional and economic burden from those affected by FSGS.
About Focal Segmental Glomerulosclerosis (FSGS)
Focal segmental glomerulosclerosis (FSGS) is a kidney disease that is characterized by scar tissue on the parts of the kidneys that filter waste from the blood, called glomeruli. When the glomeruli are damaged, it allows proteins to leak into the urine. There are three forms of FSGS: familial, primary, and secondary.
Symptoms of FSGS include protein in the urine, edema, low blood albumin levels, high creatinine levels, high cholesterol, and high blood pressure.
The cause of this condition varies, depending on the type of FSGS one has. Primary FSGS has no known cause, whereas secondary FSGS has various causes, such as kidney defects from birth, kidney reflux, obesity, obstructive sleep apnea, viruses, blood disorders, and autoimmune disorders. The familial form of the disease is caused by genetic mutations.
Various tests can diagnose this condition, including urinalysis, blood tests, and a kidney biopsy. After one obtains a diagnosis, treatment consists of steroids called prednisone or prednisolone, medications to suppress the immune system, diuretics, low salt diets, medications to block the renin angiotensin system, anticoagulants, and statins.
About the Diagnostic Technique
The majority of those with FSGS face end-stage renal failure. The best treatment for this is a kidney transplant, but about 30% of those with FSGS will not have successful transplants. Not only is the emotional burden of possible failure difficult for patients, but a failed kidney transplant is also very expensive. If they know they will not have a successful transplant, not only will that save them stress, but it will also allow them to put money towards other forms of treatment.
Dr. Nihalani and other researchers began to tackle this issue years ago, and they identified three genes that would show “increased expression levels” when they would interact with the plasma of those with recurrent FSGS. They then spent 20 years collecting samples from those with recurrent FSGS in order to test their diagnostic technique. They found that they were able to predict if someone had the recurrent form of FSGS with 80% accuracy. Their method is a novel, noninvasive way to test if one will have a failed kidney transplant.
The development of this technique has allowed Dr. Nihalani to start the company InDepth Pharmaceuticals with MUSC FRD. This company is attempting to make their diagnostic technique available for the one million people with FSGS, and they are also working to discover and create therapies for other kidney diseases.
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