{"id":254,"date":"2018-04-24T09:25:16","date_gmt":"2018-04-24T09:25:16","guid":{"rendered":"http:\/\/edren.org\/ren\/?page_id=254"},"modified":"2024-07-01T13:36:20","modified_gmt":"2024-07-01T13:36:20","slug":"fsgs","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/edren-info\/fsgs\/","title":{"rendered":"FSGS"},"content":{"rendered":"<ul style=\"list-style-type: disc;\">\n<li><a href=\"#what_is_FSGS\" data-cke-saved-href=\"#What_is_FSGS_\">What is FSGS?<\/a><\/li>\n<li><a href=\"#What_causes_scars_in_the_glomerulus\" data-cke-saved-href=\"#What_causes_scars_in_the_glomerulus_\">What causes scars in the glomerulus?<\/a><\/li>\n<li><a href=\"#Primary_FSGS_with_nephrotic_syndrome\" data-cke-saved-href=\"#Primary_FSGS_with_nephrotic_syndrome\">Primary FSGS with nephrotic syndrome<\/a><\/li>\n<li><a href=\"#Treatment_of_primary_FSGS\" data-cke-saved-href=\"#Treatment_of_primary_FSGS\">Treatment of primary nephrotic syndrome<\/a><\/li>\n<li><a href=\"#Other_causes_of_FSGS\" data-cke-saved-href=\"#Other_causes_of_FSGS\">Other causes of FSGS (secondary FSGS)<\/a><\/li>\n<li><a href=\"#Treatment_of_secondary_FSGS\" data-cke-saved-href=\"#Treatment_of_secondary_FSGS\">Treatment of secondary FSGS<\/a><\/li>\n<li><a href=\"#Summary\" data-cke-saved-href=\"#Summary\">Summary<\/a><\/li>\n<li><a href=\"#other_info\">Where can I get further information?<\/a><\/li>\n<\/ul>\n<p>Any condition that damages the glomeruli (filtering units of the kidney) in small areas may leave scars, and the kidney biopsy will then show <strong><span style=\"color: #993300;\">FSGS<\/span><\/strong> &#8211; focal segmental glomerulosclerosis. However these scars are also sometimes seen in patients with nephrotic syndrome (a heavy protein leak into the urine) but without any other reason to have scars. It is this type of FSGS, known as <strong><span style=\"color: #993300;\">Primary FSGS<\/span><\/strong>, that people usually mean when they talk about FSGS.<a id=\"what_is_FSGS\"><\/a><\/p>\n<h5><strong><span style=\"color: #993300;\">What is FSGS?<\/span><\/strong><\/h5>\n<p>Glomeruli are the filtering units of the kidney. There are about one million glomeruli in each kidney. The name <span style=\"color: #993300;\"><strong><span style=\"color: #993300;\">FSGS<\/span> <\/strong><\/span>comes about in this way:<\/p>\n<p><strong><span style=\"color: #993300;\">Focal <\/span><\/strong>means that some glomeruli are affected but not others<br \/>\n<strong><span style=\"color: #993300;\">Segmental <\/span><\/strong>affecting only a segment of each glomerulus that is involved<br \/>\n<strong><span style=\"color: #993300;\">-sclerosis <\/span><\/strong>scarring &#8230;<br \/>\n<strong><span style=\"color: #993300;\">Glomerulo- <\/span><\/strong>of the glomeruli &#8230;<\/p>\n<p>The diagnosis of <strong><span style=\"color: #993300;\">FSGS<\/span><\/strong> can only be made after these scars have been seen on a kidney biopsy.<\/p>\n\t\t\t\t\t\t<style>\r\n\t\t\t\t\t#colorbox_main_container_818 .wpsm_panel {\r\n\tmargin-bottom: 0px !important;\r\n\tbackground-color: #ffffff;\r\n\t\r\n\t\tborder: 2px solid #e6f7ed;\r\n\t\t\r\n\t\tborder-radius: 0px;\r\n\t\t}\r\n\r\n#colorbox_main_container_818 .wpsm_panel-default > .wpsm_panel-heading {\r\n\tbackground-color: #e6f7ed !important;\r\n\tborder-color: rgba(0,0,0,0.05);\r\n\tborder-top-left-radius: 0px;\r\n\tborder-top-right-radius: 0px;\r\n\ttext-align:center;\r\n}\r\n\r\n#colorbox_main_container_818 .colorbox_singel_box{\r\n  margin-bottom:20px !important;\r\n\t  padding-top: 5px;\r\n}\r\n#colorbox_main_container_818 .wpsm_panel-title{\r\n\tmargin-top: 0 !important;\r\n\tmargin-bottom: 0 !important;\r\n\tfont-size: 18px !important;\r\n\tcolor: #993300 !important;\r\n\tfont-family: Open Sans !important;\r\n\tword-wrap:break-word;\r\n\r\n}\r\n#colorbox_main_container_818 .wpsm_panel-title span{\r\n\tfont-size: 18px !important;\r\n\tcolor: #993300 !important;\r\n\t vertical-align: middle;\r\n}\r\n#colorbox_main_container_818 .wpsm_panel-body{\r\n\tcolor: #e6f7ed !important;\r\n\tbackground-color:#ffffff !important;\r\n\tfont-size:16px !important;\r\n\tfont-family: Open Sans !important;\r\n\toverflow:hidden;\r\n\ttext-align:center}\r\n\r\n \t\t\r\n\t\t\t\r\n\r\n@media (max-width: 992px){\r\n\t.colorbox_singel_box{ \r\n\t\twidth:50% !important;\r\n\t}\r\n}\r\n@media (max-width: 786px){\r\n\t.colorbox_singel_box{ \r\n\t\twidth:100% !important;\r\n\t}\r\n}\t\t\t\t<\/style>\r\n\t\t\t\t<div style=\"display:block;overflow:hidden;width:100%;\">\r\n\t\t\t\t<div id=\"colorbox_main_container_818\" style=\"colorbox_main_container\">\r\n\t\t\t\t\t\t\t\t\t\t<div class=\" wpsm_col-md-6 wpsm_col-sm-6 colorbox_singel_box\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default wpsm_panel_default_818 \">\r\n\t\t\t\t\t\t  \t\t\t\t\t\t  <div class=\"wpsm_panel-heading\">\r\n\t\t\t\t\t\t\t<h3 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\tNormal<\/h3>\r\n\t\t\t\t\t\t  <\/div> \t\t\t\t\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t<a href=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS1.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS1.jpg\" alt=\"\" width=\"220\" height=\"158\" class=\"alignnone size-full wp-image-651\" \/><\/a>\r\n<a href=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS3.gif\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS3.gif\"  alt=\"\" width=\"220\" height=\"158\" class=\"alignnone size-full wp-image-651\" \/><\/a>\r\n\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t   \r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div class=\" wpsm_col-md-6 wpsm_col-sm-6 colorbox_singel_box\">\r\n\t\t\t\t\t\t<div class=\"wpsm_panel wpsm_panel-default wpsm_panel_default_818 \">\r\n\t\t\t\t\t\t  \t\t\t\t\t\t  <div class=\"wpsm_panel-heading\">\r\n\t\t\t\t\t\t\t<h3 class=\"wpsm_panel-title\">\r\n\t\t\t\t\t\t\tFSGS<\/h3>\r\n\t\t\t\t\t\t  <\/div> \t\t\t\t\t\t\t\t\t\t\t\t \r\n\t\t\t\t\t\t <div class=\"wpsm_panel-body\">\r\n\t\t\t\t\t\t\t<a href=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS2.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS2.jpg\"  alt=\"\" width=\"220\" height=\"158\" class=\"alignnone size-full wp-image-651\"\/><\/a>\r\n<a href=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS4.gif\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/edren.org\/ren\/wp-content\/uploads\/2018\/05\/FSGS4.gif\"  alt=\"\" width=\"220\" height=\"158\" class=\"alignnone size-full wp-image-651\" \/><\/a>\t\t\t\t\t\t  <\/div>\r\n\t\t\t\t\t\t   \r\n\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\n<p>What <strong><span style=\"color: #993300;\">FSGS<\/span><\/strong> looks like on a kidney biopsy. A normal glomerulus (<span style=\"color: #993300;\">left<\/span>), and one with a scar affecting one segment (<span style=\"color: #993300;\">right<\/span> &#8211; the scar is shown in pink in the diagram below). The top two pictures are from kidney biopsies. The &#8216;holes&#8217; in the middle of the glomerulus are filled with flowing blood in life. The two below are diagrams showing the space into which urine is filtered (white), and a scar (pink). Each glomerulus is tiny &#8211; you could fit 10 side by side on the head of a pin. See where they are in <a href=\"[wblink154]\" data-cke-saved-href=\"[wblink154]\">normal function of the kidney<\/a>.<\/p>\n<h5><strong><span style=\"color: #993300;\">What causes scars in the glomerulus?<\/span><\/strong><\/h5>\n<p>There are many possible causes &#8211; other information besides the kidney biopsy is needed to decide between them. This table shows more causes than most doctors will remember.<\/p>\n<table class=\" cke_show_border\" border=\"0\" width=\"450\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td style=\"background-color: #f7f4ad;\" colspan=\"2\" bgcolor=\"#ffffcc\"><strong><span style=\"color: #993300;\">Primary FSGS<\/span><\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #f7f4ad;\" colspan=\"2\" bgcolor=\"#ffffcc\">Usually causes nephrotic syndrome. None of the things below can explain the scars.<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" colspan=\"2\" bgcolor=\"#ccccff\"><strong><span style=\"color: #993300;\">Secondary FSGS<\/span><\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" colspan=\"2\" bgcolor=\"#ccccff\">\u00a0&#8211; all other types; including the following causes:<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" colspan=\"2\" bgcolor=\"#ccccff\"><span style=\"color: #993300;\"><strong>Previous diseases affecting tiny blood vessels in glomeruli<\/strong>,<\/span> eg.<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" valign=\"top\" bgcolor=\"#ccccff\" width=\"28%\" height=\"50\">HUS (haemolytic uraemic syndrome)<\/td>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" width=\"64%\" height=\"50\">HUS is a complication of E.coli O157 diarrhoea in childhood. There are other possible causes, particularly in adults<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" valign=\"top\" bgcolor=\"#ccccff\" width=\"28%\" height=\"74\">Cholesterol emboli<\/td>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" width=\"64%\" height=\"74\">Lumps of cholesterol block tiny blood vessels. These occur in people with narrowing of the arteries caused by atherosclerosis &#8211; most likely in smokers, those with high blood cholesterol, and those with evidence of narrowing of arteries elsewhere<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" height=\"42\">\u00a0<strong><span style=\"color: #993300;\">Toxins<\/span><\/strong><\/td>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" width=\"64%\" height=\"42\">Probably &#8211; but in humans we don&#8217;t know precisely which ones<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" height=\"42\">\u00a0Genetic<\/td>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" width=\"64%\" height=\"42\">An unusual inherited disease.<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" height=\"42\"><span style=\"color: #993300;\">\u00a0Other<\/span><\/td>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ccccff\" width=\"64%\" height=\"42\">eg. HIV infection;\u00a0 severe obesity (it must be very severe)<a id=\"Primary_FSGS_with_nephrotic_syndrome\"><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h5><strong><span style=\"color: #993300;\">Primary FSGS with nephrotic syndrome<\/span><\/strong><\/h5>\n<p>This disease usually comes to attention by causing nephrotic syndrome, and sometimes by causing kidney failure and high blood pressure. Although it has some things in common with another common cause of nephrotic syndrome, <a href=\"[wblink152]\" data-cke-saved-href=\"[wblink152]\"><span style=\"font-family: Arial;\">minimal change disease<\/span><\/a>, it also has some important differences:<\/p>\n<ul style=\"list-style-type: disc;\">\n<li>Occurs at all ages &#8211; not common in children<\/li>\n<li>Sometimes responds to steroid treatment (instead of almost always)<\/li>\n<li>Kidney function may be abnormal, and may get worse<\/li>\n<li>Can cause complete kidney destruction requiring dialysis and transplantation<\/li>\n<li>The disease may come back after a kidney transplant to affect the transplanted kidney<\/li>\n<\/ul>\n<p>Minimal change disease is a common cause of nephrotic syndrome in which the glomeruli look completely normal on kidney biopsy. Occasionally FSGS may be mistaken for minimal change disease on the kidney biopsy, simply because the biopsy missed any of the glomeruli with scars in them.<a id=\"Treatment_of_primary_FSGS\"><\/a><\/p>\n<h5><strong><span style=\"color: #993300;\">Treatment of primary FSGS<\/span><\/strong><\/h5>\n<p>Primary FSGS may be treated with high doses of steroids, as is given to patients with nephrotic syndrome caused by Minimal Change Disease. If the dose is high enough and continued for long enough, the nephrotic syndrome may improve in many patients. However some will not respond, and in others, the side effects may be very troublesome. Other treatments may help in some people \u00ad mostly these are drugs that affect the immune system. Some further details of steroid and other treatments is available from our information on <span style=\"font-family: Arial;\"><a href=\"http:\/\/edren.org\/ren\/edren-info\/immunosuppressive-drugs-for-renal-disease\/\" data-cke-saved-href=\"[wblink148]\">Immunosuppressive Drugs for Renal Diseases<\/a>. If kidney function is reduced, treatments to prevent further deterioration are very important. See our information on <a href=\"http:\/\/edren.org\/ren\/edren-info\/ckd-chronic-renal-failure-and-its-progression\/\" data-cke-saved-href=\"[wblink133]\">chronic renal failure and its progression<\/a><\/span> for further information. Treatment is likely to include strict blood pressure control, and may include dietary and other recommendations.<a id=\"Other_causes_of_FSGS\"><\/a><\/p>\n<h5><strong><span style=\"color: #993300;\">Other causes of FSGS (secondary FSGS)<\/span><\/strong><\/h5>\n<p>FSGS with other causes may come to light because of proteinuria, raised blood pressure, or because of signs from blood tests that the kidneys are not working properly (renal failure).<a id=\"Treatment_of_secondary_FSGS\"><\/a><\/p>\n<h5><strong><span style=\"color: #993300;\">Treatment of secondary FSGS<\/span><\/strong><\/h5>\n<p>The treatments for these types of FSGS will differ according to the probable cause. In fact many of them do not require any special treatment \u00ad often the scars are from a disease that has occurred in the past. However if there is enough damage to reduce kidney function, treatments to prevent further deterioration are very important. See our information on <a href=\"[wblink133]\" data-cke-saved-href=\"[wblink133]\"><span style=\"font-family: Arial;\">chronic renal failure and its progression<\/span><\/a> for further information. Treatment is likely to include strict blood pressure control, and may include dietary and other recommendations.<a id=\"Summary\"><\/a><\/p>\n<h5><strong><span style=\"color: #993300;\"><img class=\"cke_anchor\" title=\"Summary\" \/>Summary<\/span><\/strong><\/h5>\n<table class=\" cke_show_border\" border=\"0\" width=\"450\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ffffcc\" width=\"92%\">FSGS causes proteinuria and kidney damage, often with nephrotic syndrome. It can only be diagnosed after a kidney biopsy<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ffffcc\" width=\"92%\">In some patients it responds to treatment with steroids<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ffffcc\" width=\"92%\">In some it may cause progressive renal failure<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #e6f7ed;\" bgcolor=\"#ffffcc\" width=\"92%\">FSGS can also be sometimes just a sign of previous kidney disease<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<h5><strong><span style=\"color: #993300;\"><a id=\"other_info\"><\/a>Other information<\/span><\/strong><\/h5>\n<div class=\"bigbox2\">\n<p>Our own literature and website, <a href=\"http:\/\/edren.org\/ren\/edren-info\/\" data-cke-saved-href=\"[wblink11]\">EdRenINFO<\/a>, has further information on <strong><span style=\"color: #993300;\">nephrotic syndrom<\/span>e<\/strong> (very relevant), <strong><span style=\"color: #993300;\">chronic renal failure and its progression<\/span>, <span style=\"color: #993300;\">minimal change disease<\/span><\/strong>, and <strong><span style=\"color: #993300;\">proteinuria<\/span><\/strong>.<\/p>\n<p>There is a good, <a href=\"http:\/\/www.kidney.org.uk\/Medical-Info\/kidney-disease\/fsgs.html\" data-cke-saved-href=\"http:\/\/www.kidney.org.uk\/Medical-Info\/kidney-disease\/fsgs.html\">short article on FSGS on the NKF-UK<\/a> website.<\/p>\n<p>Some very helpful <a href=\"http:\/\/www.nephcure.org\/Patient_Stories\" data-cke-saved-href=\"http:\/\/www.nephcure.org\/Patient_Stories\">patient&#8217;s stories<\/a> can be found on the Nephcure site. Nephcure is a US support organisation that raises funds for research. In the UK, the <a href=\"http:\/\/www.nkrf.org.uk\/\" data-cke-saved-href=\"http:\/\/www.nkrf.org.uk\/\">NKRF<\/a> is the major charity supporting renal research.<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 12pt;\"><strong>Acknowledgements:<\/strong>\u00a0 The author of this page was Neil Turner. It was first published in September 2000 and reviewed by Ben Reynolds in May 2010. The date is was last modified is shown in the footer.<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>What is FSGS? What causes scars in the glomerulus? Primary FSGS with nephrotic syndrome Treatment of primary nephrotic syndrome Other causes of FSGS (secondary FSGS) Treatment of secondary FSGS Summary Where can I get further information? Any condition that damages the glomeruli (filtering units of the kidney) in small areas\u2026<\/p>\n<p> <a class=\"continue-reading-link\" href=\"https:\/\/edren.org\/ren\/?p=818\"><span>Continue reading<\/span><i class=\"crycon-right-dir\"><\/i><\/a> <\/p>\n","protected":false},"author":2,"featured_media":0,"parent":220,"menu_order":150,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-254","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/254","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/comments?post=254"}],"version-history":[{"count":25,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/254\/revisions"}],"predecessor-version":[{"id":835,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/254\/revisions\/835"}],"up":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/220"}],"wp:attachment":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/media?parent=254"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}