Focal Segmental Glomerulosclerosis (FSGS)

What is Focal Segmental Glomerulosclerosis?

Often linked to primary glomerular diseases in adults, focal segmental glomerulosclerosis (FSGS) is a type of kidney disease that’s progressive in nature. FSGS attacks tiny structures in the kidneys that play a role in the process of filtering blood called glomeruli. Treatment of the condition can be difficult, especially if there are contributing factors.

What are the Symptoms of Focal Segmental Glomerulosclerosis?

There is no definitive cause of FSGS. Related causes can be a persistent infection, diminished kidney functioning, sickle cell disease, obesity, illicit drug use, diabetes, and a compromised immune system. FSGS can be primary, meaning it developed with no related factors, or secondary to preexisting conditions. The scarring resulting from the condition initially effects some of the kidney’s filtering structures. FSGS may eventually lead to end-stage renal disease for some patients.

Symptoms include

  • Excessively high blood pressure
  • Abdominal pain
  • Rapid progression of existing kidney issues
  • Reduced response to corticosteroids
  • Visible swelling in multiple parts of the body
  • Consistently high cholesterol

Focal Segmental Glomerulosclerosis Causes

Focal segmental glomerulosclerosis, or FSGS, has many different causes. More often than not, however, people with FSG can point to nothing specific as the cause of their disease. Genetics, infections, and diseases that affect the entire body can cause FSGS, such as diabetes, HIV, sickle cell infections, and lupus. Obesity and obstructive sleep apnea may also play a role. Since FSGS affects the kidneys, kidney defects from birth can also have an effect on a person’s chance of developing FSGS. Drugs such as heroin anabolic steroids (steroids used to rapidly increase muscle growth) can also cause FSGS in people. In addition, FSGS can be caused by other glomerular diseases occurring previously. When the disease occurs with no known or distinguishable cause, it is referred to as primary FSGS. This is the most common kind of FSGS. Secondary FSGS is FSGS that occurs as a result of a known condition and is the most common kind of FSGS by far.

How is Focal Segmental Glomerulosclerosis Treated?

Diagnosis includes a biopsy, blood tests, lipid studies, urine analysis, imaging, and an evaluation of medical history. Treatment usually starts with efforts to slow progression and reduce the risk of experiencing kidney failure.

Treatment includes

  • Patient counseling to encourage healthy eating choices and increase awareness of symptoms
  • Dialysis
  • Controlling hypertension
  • Immunosuppressants and diuretics (among other medications)
  • Long-term corticosteroid therapy

As focal segmental glomerulosclerosis advances, kidney functioning is impacted to a greater extent. FSGS often requires a combination of treatment and management efforts and careful monitoring of symptoms and kidney functioning. With effective management, including lifestyle and dietary adjustments, some patients experience a partial or complete remission. A kidney transplant is only considered an option if FSGS leads to end-stage renal disease.

Focal Segmental Glomerulosclerosis Prevention

Due to the fact that there are many diverse causes of focal segmental glomerulosclerosis, there is no specific way to prevent it. As FSGS has no obvious cause in most cases, it is impossible to predict. Scientists and doctors do not yet fully understand FSGS. However, there are some small risk factors that a person can control. Since drugs that affect the entire body (among them heroin, anabolic steroids, and certain medications) can cause FSGS, avoiding them may lower one’s chances of contracting the disease. Since obesity may also play a role in obtaining FSGS, maintaining a healthy weight and diet is beneficial, both in this case and to generally maintain a healthy lifestyle. Obstructive sleep apnea, too, is something that can be treated with a doctor’s aid and may lower one’s risk of obtaining FSGS.

Last Reviewed:
September 21, 2016
Last Updated:
December 22, 2017