Focal segmental glomerulosclerosis
Introduction
Focal segmental glomerulosclerosis (FSGS) is a cause of nephrotic syndrome and chronic kidney disease. It generally presents in young adults.
Epidemiology
- Incidence: 1.50 cases per 100,000 person-years
- Peak incidence: 20-30 years
- Sex ratio: more common in males 1.5:1
| <1 | 1-5 | 6+ | 16+ | 30+ | 40+ | 50+ | 60+ | 70+ | 80+ |
Aetiology
Causes
Focal segmental glomerulosclerosis is noted for having a high recurrence rate in renal transplants.
- idiopathic
- secondary to other renal pathology e.g. IgA nephropathy, reflux nephropathy
- HIV
- heroin
- Alport's syndrome
- sickle-cell
Focal segmental glomerulosclerosis is noted for having a high recurrence rate in renal transplants.
Clinical features
Symptoms
- Swelling around the eye (80%)
- Facial swelling (60%)
- Non-visible haematuria (50%)
Signs
- Nephrotic syndrome (80%)
- Weight gain (40%)
- Bilateral distal leg swelling (40%)
Investigations
- Proteinuria (90%)
Investigations
Investigations
- renal biopsy
- focal and segmental sclerosis and hyalinosis on light microscopy
- effacement of foot processes on electron microscopy
Management
Management
- steroids +/- immunosuppressants
Prognosis
Prognosis
- untreated FSGS has a < 10% chance of spontaneous remission