Definition

Focal segmental glomerulosclerosis is scar tissue that forms in areas of the kidney that filter certain things out of the body. These areas are called glomeruli. The help the body get rid of harmful or unnecessary substances. Each kidney has thousands of glomeruli.

"Focal" means that some of the glomeruli become scarred, while others remain normal. "Segmental" means that only part of an individual glomerulus is damaged.

Alternative Names

Segmental glomerulosclerosis; Focal sclerosis with hyalinosis

Causes, incidence, and risk factors

The cause of focal segmental glomerulosclerosis is usually unknown. A small number of cases result from reflux nephropathy. The condition affects both children and adults. Males are affected slightly more often than females, and it also occurs more frequently in African Americans.

Focal segmental glomerulosclerosis causes about 10 - 15% of all cases of nephrotic syndrome.

Symptoms

• Foamy urine
• Swelling of the body, called generalized edema, from retained fluids
• Weight gain
• Poor appetite

Signs and tests

There are no strong clues to the diagnosis on physical examination, other than evidence of edema and elevated blood pressure. Signs of kidney renal failure and associated fluid overload may develop as the illness gets worse.

Tests may include:

• Urinalysis
• Kidney biopsy
• Immunofluorescence microscopy test

Treatment

The goal of treatment is to control the symptoms associated with nephrotic syndrome and chronic kidney failure. For detailed treatment information for those conditions, see:

• Nephrotic syndrome
• Chronic kidney failure

In general, treatments may include:

• Low or moderate protein diet (1 gram of protein per kilogram of body weight per day)
• Low fat diet
• Salt-free diet
• Fluid restriction
• Powerful anti-inflammatory medicines to reduce the immune response
• Medicines to treat high blood pressure, high blood cholesterol, and high triglyceride levels
• Antibiotics to control infections
• Vitamin D supplementation
• Dialysis
• Kidney transplantation

See also: Kidney disease - diet

Support Groups

Expectations (prognosis)

Over half of all persons with focal or segmental glomerulosclerosis develop chronic kidney failure within 10 years.

Complications

• Chronic kidney failure
• End-stage kidney disease
• Nephrotic syndrome
• Malnutrition
• Infection

Calling your health care provider

You should call your doctor if symptoms develop, especially if there is fever, pain with urination, or decreased urine output.

Prevention

No prevention is known.

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