Focal Segmental Glomerulosclerosis (FSGS)

What is FSGS?

Focal segmental glomerulosclerosis (FSGS) is a disease where scar tissue forms on areas of the kidneys that filter waste from the blood, which is called glomeruli. FSGS is one of the causes of nephrotic syndrome.

Kidneys are made up of about a million tiny filters called glomeruli. Glomeruli filter blood, taking out the water-like the substance that becomes urine and leaving in protein. When glomeruli become damaged or scarred, proteins begin leaking into the urine.

There are three types of FSGS:

Primary FSGS
Secondary FSGS
Genetic (or familial) FSGS

What are the symptoms of FSGS?

Protein in urine
Edema (swelling around eyes, hands, feet, and abdomen)
Low blood albumin levels
High levels of creatinine
High cholesterol
High blood pressure

What causes FSGS?

The cause depends on the type of FSGS:

Primary FSGS – idiopathic, i.e. has no known cause
Secondary FSGS – caused by:
- Kidney defects from birth (dysplasia)
- Urine backing up into kidneys (kidney reflux)
- Obesity
- Obstructive Sleep Apnea
- Viruses and blood disorders
- Autoimmune disorders (such as lupus and HSP)
Genetic (or familial) FSGS – caused by genetic mutations.

How is FSGS diagnosed?

Medical exams to help reach a diagnosis include:

Urinalysis
Blood tests to check cholesterol level
Kidney biopsy

What are the treatments for FSGS?

Treatments include:

A steroid called prednisone or prednisolone to mitigate proteinuria
Medications that suppress the immune system
Diuretics and low salt diet help to control edema
Medication that blocks a hormone system called the renin angiotensin system to control blood pressure or lower urine protein
Anticoagulants
Statins to lower cholesterol