Focal segmental glomerulosclerosis

• Alternative Names

  Segmental glomerulosclerosis; Focal sclerosis with hyalinosis

• Causes, incidence, and risk factors

  The cause of focal segmental glomerulosclerosis is usually unknown. A small number of cases result from reflux nephropathy. The condition affects both children and adults. Men and boys are affected slightly more often than women and girls, and it also occurs more frequently in African-Americans. There are also rare, inherited forms of focal segmental glomerulosclerosis.

  Focal segmental glomerulosclerosis causes about 10 - 15% of all cases of nephrotic syndrome.

• Symptoms
  • Foamy urine
  • Poor appetite
  • Swelling of the body, called generalized edema, from retained fluids
  • Weight gain
• Signs and tests

  The health care provider will perform and physicla examination. This condition is diagnosed based on edema and elevated blood pressure. Signs of kidney (renal) failure and associated fluid overload may develop as the condition gets worse.

  Tests may include:

  • Immunofluorescence microscopy test
  • Kidney biopsy
  • Urinalysis
• Treatment

  Some patients will receive high doses of corticosteroids or a drug called cyclosporine. It is not clear, however, whether these drugs can prevent the kidneys from eventually failing.

  The goal of treatment is to control the symptoms associated with nephrotic syndrome and chronic kidney failure.

  See also:

  • Chronic kidney failure
  • Nephrotic syndrome

  In general, treatments may include:

  • Antibiotics to control infections
  • Dialysis
  • Fluid restriction
  • Kidney transplantation
  • Low fat diet
  • Low or moderate protein diet (1 gram of protein per kilogram of body weight per day)
  • Medicines to treat high blood pressure, high blood cholesterol, and high triglyceride levels
  • Powerful anti-inflammatory medicines to reduce the immune response
  • Salt-free diet
  • Vitamin D supplementation

  See also: Kidney disease - diet

• Expectations (prognosis)

  More than half of those with focal or segmental glomerulosclerosis develop chronic kidney failure within 10 years.

• Complications
  • Chronic kidney failure
  • End-stage kidney disease
  • Infection
  • Malnutrition
  • Nephrotic syndrome
• Calling your health care provider

  You should call your doctor if you develop symptoms of this condition, especially if there is fever, pain with urination, or decreased urine output.

• Prevention

  No prevention is known.

• References

  Nachman PH, Jennette JC, Falk, RJ. Primary Glomerular Disease. In: Brenner BM, ed. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa; Saunders Elsevier; 2007: chap 30.

Review Date: 5/20/2009

Reviewed By: Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.