Post Date April, 15 2023
What is focal segmental glomerulosclerosis (FSGS)?
The glomerulus is a tiny filtration unit in the kidney that purifies blood. Many diseases and conditions can affect renal function by attacking and damaging the glomerulus. These are known as "glomerular diseases" and have a variety of causes.
FSGS is a type of glomerular disease that describes scars (sclerosis) in the kidney. Scarring of FSGS occurs only in a small segment of each glomerulus, and initially only a limited number of glomeruli are damaged. FSGS affects children and adults. The incidence rate of male is slightly higher than that of female, and it is more common among African Americans.
What is the cause of focal segmental glomerulosclerosis (FSGS)?
FSGS is not caused by a single disease, and its etiology is diverse. Scars may be caused by infection, or drugs or some disease that affects the whole body (such as diabetes, HIV infection, sickle cell disease or systemic lupus erythematosus). FSGS may also be caused by another glomerular disease you previously had. There are different types of FSGS depending on the etiology:
Primary FSGS: This type of FSGS means that it is caused by the kidney itself, rather than by other known causes.
Secondary FSGS: This type of FSGS is usually caused by other diseases or drugs. Examples include viral infections (such as HIV), drugs (such as anabolic steroids that some people use to accelerate their muscle growth). This anabolic steroid is different from the hormonal drugs prescribed by doctors for therapeutic purposes.
What are the signs and symptoms of focal segmental glomerulosclerosis (FSGS)?
Early stages may not produce any symptoms. The symptoms and signs of FSGS include: (1) swelling in certain parts of the body, such as the legs, ankles, and around the eyes, known as "edema.". (2) Weight gain caused by water accumulation in the body. (3) Foam urine (called "proteinuria") caused by the loss of a large amount of protein in urine. (4) Increased blood fat levels (hypercholesterolemia). (5) Blood protein levels decreased.
FSGS can cause nephrotic syndrome (NS). NS is a group of clinical syndromes characterized by: (1) swelling of certain parts of the body, such as the legs, ankles, and around the eyes, known as "edema.". (2) There is a large amount of protein in the urine, called "albuminuria.". (3) Increased blood lipid levels (hypercholesterolemia). (4) Elevated blood pressure levels (seen in some cases).
If the condition is more severe, the symptoms of FSGS may resemble those of renal failure. People may complain of fatigue, loss of appetite, headache, itchy skin, shortness of breath, and/or nausea.
What tests can be done to determine whether it is focal segmental glomerulosclerosis (FSGS)?
Blood tests, urine tests, and kidney biopsies can identify the presence or absence of FSGS.
Urine examination: It can help detect proteins and blood in urine.
2. Blood examination: It can help clarify the levels of protein, cholesterol, and metabolic waste in the blood.
Glomerular filtration rate (GFR): A blood test will be conducted to understand the ability of the kidneys to filter waste from the body.
"Kidney biopsy: In this examination, a special needle is used to remove a small portion of the tissue from the kidney and observe it under a microscope.".
5. Genetic testing: It may be necessary to conduct genetic testing to understand whether genes are causing kidney disease. This information may help doctors decide which treatment is most suitable.
How to treat focal segmental glomerulosclerosis (FSGS)?
The choice of treatment depends on the etiology. Everyone's situation is different, and doctors will develop treatment plans that are suitable for the type of FSGS. The treatment methods for FSGS usually include the following aspects:
Glucocorticoids and immunosuppressive drugs: These drugs are used to calm the immune system (the body's defense system) and stop attacking the glomerulus.
ACEI or ARB drugs: These are antihypertensive drugs that are used to reduce urinary protein loss and control blood pressure.
Diuretics: Helps the body expel excess fluid and reduce swelling. These can also help lower blood pressure.
4. Changing dietary habits: Some dietary habits may need to be changed, such as reducing the intake of salt (sodium) and protein in food, to reduce the burden of waste metabolism on the kidneys.
5. Plasma exchange: For some refractory cases, remove circulating factors from the pathogenic blood.
Can renal failure occur due to focal segmental glomerulosclerosis (FSGS)?
You should discuss the condition with your doctor, as the progress of the disease depends on many factors. FSGS is a chronic disease that cannot repair the scarred glomeruli. Treatment can delay the progression of kidney disease. Everyone's response to treatment varies. Over time, some patients with FSGS gradually deteriorate and eventually reach renal failure. If this happens, they need a kidney transplant or dialysis to maintain life. Some people respond well to treatment and may survive with the disease for many years, requiring only regular monitoring of changes in physical signs.
