Focal segmental glomerulosclerosis

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, obesity, medications, and 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. Secondary form requires treatment of the underlying cause.

Corticosteroid-dependent and corticosteroid-resistant patients require treatment with other immunosuppressants such as cyclosporine.

Prognosis is extremely variable and depends on the amount of proteinuria, the level of plasma creatinine, the morphologic subtype, the degree of renal fibrosis, and the response to therapy.

Focal segmental glomerulosclerosis (FSGS) is a chronic pathologic process caused by injury to podocytes in the renal glomeruli. It manifests initially with proteinuria, which progresses to nephrotic syndrome and ultimately to end-stage renal failure.