Focal segmental glomerulosclerosis

Your kidney can be affected by a wide range of diseases and conditions causing damage to the glomeruli. The glomerulus is the tiny filtering unit of your kidney where the toxic substances from your blood are removed. The glomerulus is also involved in the formation of urine. The diseases that affect your glomeruli are termed as glomerular diseases. Focal segmental glomerulosclerosis (FSGS) is termed to describe scarring of certain parts of glomeruli in your kidney.

Focal segmental glomerulosclerosis may occur in any of the age groups, especially, in children and adults. Males are more likely to develop this condition than females.

Signs and symptoms

You may not experience any symptoms in the early stages. If the condition is moderate to severe, you may experience the following signs and symptoms:

  • Swelling of your legs, ankles and around eyes
  • Weight gain due to increase in the body fluids
  • Foamy urine due to high levels of proteins in the urine
  • Poor appetite
  • High blood pressure
  • Elevated levels of blood cholesterol
  • Low levels of proteins in your blood

When to seek medical advice?

Notify your doctor if you experience the following symptoms of kidney failure:

  • Pain while urinating
  • Decreased urine output
  • High body temperature

Complications

Following are the possible complications of FSGS:

  • Chronic kidney disease
  • Infection
  • Malnutrition
  • Nephritic syndrome
  • End-stage renal disease
  • Kidney stones
  • Lupus nephritis (inflammation of the kidney)
  • Kidney scarring

Self-management

To reduce the progression of your kidney failure, your doctor might advise certain measures that include the following:

  • Follow a healthy diet that includes low sodium foods
  • Avoid medications such as non-steroid anti-inflammatory drugs that cause renal failure
  • Take vitamin D supplements
  • Quit smoking
  • Reduce the body weight if you’re overweight or obese
  • Perform regular physical activity
  • Avoid the foods rich in saturated fats and cholesterol

The diagnosis involves assessing your kidney function by reviewing your medical history and certain laboratory tests. Your doctor might order any of the following tests to confirm the diagnosis.

  • Urinalysis :A sample of urine is examined for the presence of proteins and blood. It also helps to identify the possible cause of FSGS.
  • Blood tests : The blood tests help to determine the levels of proteins and cholesterol.
  • Glomerular filtration rate (GFR) : GFR is performed to identify the ability of your kidney in removing the waste products. It is used to estimate the percentage of the kidney function that is left.
  • Kidney biopsy : small piece of your kidney is removed and examined under the microscope.
  • Genetic testing : In rare conditions, your doctor might order genetic testing and identifies the genes causing kidney disease.

    Your doctor recommends the nephritic syndrome treatment based on the underlying cause. Your doctor might order any of the following medications:

    • Corticosteroids and immunosuppressive drugs are used to suppress your immune system and prevent the further damage of your glomeruli.
    • Angiotensin-converting enzyme inhibitors  are used to reduce your blood pressure and loss of protein.
    • Diuretics help in removing excess fluids from your body and reduce the swelling.
    • In severe conditions, your doctor might suggest dialysis or kidney transplant.

    It is not a single factor that causes, there are multiple. Sometimes, the cause of FSGS remains unknown. The scars may result from an infection, use of certain drugs, or conditions such as diabetes, sickle cell anemia, or HIV infection. A history of other glomerular diseases may also cause FSGS. The different types of FSGS are listed below:

    • Primary FSGS : If the condition occurs with an unknown cause, then it is termed as primary FSGS.
    • Secondary FSGS : This type of FSGS is caused due to an underlying condition or any medication such as anabolic steroids. The underlying conditions such as kidney damage, obesity, or diabetes.
    • Genetic FSGS : This type is very rare and caused by mutations in your genes. Your doctor will suspect genetic reasons if any of your family members have had a history of FSGS.