Focal Segmental Glomerulosclerosis FSGS


FSGS stands for Focal Segmental Glomerulosclerosis and is a relatively common form of kidney disease, especially in the US. Although there are several known risk factors, we don’t yet know why most people develop FSGS.

FSGS is named for the scarring, or “sclerosis,” that can be found in the kidney of people with this disease.

When looked at under a microscope, all kidneys contain millions of tiny filters called “glomeruli”. These filters work much like a colander that you might have in your kitchen. Blood is “poured into them” as it circulates through the kidney, and the water-like part of the blood drains through. This becomes your urine. When these filters are damaged they become scarred. They are no longer able to filter blood appropriately. This is called “glomerulosclerosis”.

The word “focal” is added because in FSGS, only some of the filters are damaged. “Segmental” is included because often only parts of the filters are scarred.


About Focal Segmental Glomerulosclerosis

The cause is FSGS in unknown, it is generally broken down into primary and secondary.

Primary means that the disease happens on its own, for no obvious reasons.

Secondary means that we think the FSGS was caused by, or is associated with, another medical conditions such as:

  • Kidney defects
  • Urine backing up into kidneys
  • Obesity
  • Obstructive Sleep Apnea
  • Sickle Cell Anemia
  • Viruses (such as HIV)

Most people with the above conditions do not have FSGS. Having FSGS does NOT put you at risk for any of these conditions you do not already have.

Like most other types of CKD, FSGS have no symptoms.  However, the most common complaint seen is edema, or swelling, especially in the legs.

High blood pressure, or hypertension, is also a very common finding. The hypertension in people with FSGS can often be very difficult to treat.

Proteinurnia or large amount of protein in the urine is common with this diagnosis.

None of the above symptoms, or even all of them together, can diagnose FSGS.

Monitoring of this disease kidney specialist, also called a nephrologist is important and also to be treated for any of the associated with any of the predisposing illnesses such as:

  • Kidney defects
  • obstructions
  • Obesity
  • Obstructive Sleep Apnea
  • Sickle Cell Anemia
  • Viruses (such as HIV)

Or any underlying condition that may be the cause, while monitoring and treating the hypertension.

Treating the cause becomes in this particular illness becomes a priority.

There are medications that can be taken to help reduce the amount of protein in the urine. These medications are called ACE-inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers).

In addition to the above, many different types of drugs that suppress the immune system are also being used to treat FSGS.

Your nephrologist may recommend a kidney biopsy if they are considering FSGS as a diagnosis, to assure an accurate diagnosis and to help direct your treatment options, however, because only some sections of the glomeruli are affected, the biopsy can sometimes be inconclusive.

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