Focal Segmental Glomerulosclerosis: Causes, Types, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Focal segmental glomerulosclerosis (FSGS) is a disease characterized by the formation of scar tissue on the glomeruli, which are the small parts of the kidneys that filter waste out of the blood. A wide range of factors can lead to FSGS.

FSGS is a serious illness that can lead to renal failure; the only effective treatments are dialysis or kidney transplantation. Your available treatment options will depend on the type of FSGS you have.

Causes Of Focal Segmental Glomerulosclerosis

Focal segmental glomerulosclerosis (FSGS) can be brought on by diabetes, sickle cell disease, other kidney diseases, obesity, and other conditions. Infections and injuries from pharmaceuticals, poisons, and illicit drugs can also cause it. 

Hereditary gene changes or gene mutations passed down through the generations, can cause a rare form of FSGS. There are instances where the cause is uncertain.

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Types Of Focal Segmental Glomerulosclerosis

FSGS kinds consist of:

• Primary FSGS: The etiology of FSGS is unknown in many cases of diagnosed patients. Basic (idiopathic) FSGS is what we call it.
• Secondary FSGS: Numerous situations, including infections, drug toxicity, diseases like sickle cell disease or diabetes, obesity, and even other kidney abnormalities, can result in secondary FSGS. Managing or treating the underlying cause often slows down the rate of renal degeneration and eventually leads to enhanced kidney function.
• Genetic FSGS: This particular kind of FSGS is uncommon and driven by genetics. Familial FSGS is another name for it. Suspicion is aroused when several family members display FSGS symptoms. Furthermore, if neither parent has the disorder, familial FSGS may result from a scenario in which one or both parents have a mutant gene copy that can be passed on to their children.
• Unknown FSGS: Not all cases of FSGS have a known underlying aetiology, even after extensive testing and evaluation of clinical symptoms.

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Symptoms Of Focal Segmental Glomerulosclerosis

The following are possible symptoms of focal segmental glomerulosclerosis (FSGS):

• Swelling of the legs, ankles, eyes, and other body regions is known medically as edema.
• Weight gain brought on by fluid retention.
• Foaming urine due to protein build-up is known as proteinuria.

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Risk Factors Of Focal Segmental Glomerulosclerosis

Focal segmental glomerulosclerosis (FSGS) risk factors include the following:

• Diseases that could affect renal function: A few illnesses and disorders can raise the risk of acquiring FSGS. These include renal diseases such as diabetes, lupus, and obesity.
• Certain infections: HIV and hepatitis C both increase the risk of FSGS.
• Changes in genes: several genes that run in families that can increase the risk of FSGS.

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Diagnosis Of Focal Segmental Glomerulosclerosis

To rule out focal segmental glomerulosclerosis (FSGS), your physician will review your medical history and do laboratory tests to evaluate kidney function. Possible test components include:

• Urine examinations: Counting the amount of protein and other chemicals in the urine over 24 hours is one of these.
• Blood tests: One blood test used to measure the kidneys' effectiveness in eliminating waste from the body is called the glomerular filtration rate.
• Kidney imaging: These tests are useful in determining the size and structure of kidneys. CT, MRI, and ultrasound scans could be among them. One may also use studies related to nuclear medicine.
• Renal biopsy: To obtain a small kidney sample, a biopsy usually involves passing a needle through the skin. the biopsy's findings can verify a diagnosis of FSGS.

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Treatment Of Focal Segmental Glomerulosclerosis

The kind and cause of focal segmental glomerulosclerosis (FSGS) determine the course of treatment.

Drugs

Medications for treating familial simple sclerosis (FSGS) may include:

• Either an angiotensin II receptor blocker (ARB) or an inhibitor of the angiotensin-converting enzyme (ACE). These can lower blood pressure and urine protein levels.
• Drugs that reduce cholesterol levels. FSGS patients frequently have elevated cholesterol.
• Diuretics are medications that aid the body in eliminating water and salt. These can reduce edema and blood pressure.
• Medications that reduce the immune system's reaction. These medications may prevent renal damage from the immune system in cases of primary FSGS. Among these medications are corticosteroids. They are taken cautiously since they may have major negative effects.

There is a chance that FSGS will return. You should periodically check on the health of your kidneys by consulting your healthcare team, as glomerular scarring may not go away. Patients with renal failure can receive dialysis or a kidney transplant as therapies.

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Complications Of Focal Segmental Glomerulosclerosis

Other health problems associated with focal segmental glomerulosclerosis (FSGS) include the following:

• Nephrotic syndrome: This kidney condition causes the body to discharge an excessive amount of protein in the urine. Among the conditions that are more common in those with nephrotic syndrome are blood clots and high blood pressure.
• Kidney failure: A renal injury that cannot be reversed leads to kidney failure. Renal failure can be treated with dialysis or a kidney transplant.

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