Focal Segmental Glomerulosclerosis

Abstract

Focal segmental glomerulosclerosis is an important cause of the nephrotic syndrome in children and adults. This paper reviews the pathogenesis, clinical manifestations, morphology, and treatment of focal glomerulosclerosis. In addition, it considers the recently described association of focal glomerulosclerosis with nonglomerular renal diseases and the possible role of this glomerular lesion in progressive renal failure.

Renal Lesions of Hyperlipidemic Imai Rats: A Spontaneous Animal Model of Focal Glomerulosclerosis

“…In addition, Zucker rats, a unique rat strain which spontaneously shows obesity, hyperglycemia and glomerulosclerosis, have also been used as a useful ani mal model [14]. Although several parameters have been identified as possible pathogenetic factors of FGS in these animals [1,2], the causes of FGS in humans are far less known, partly because of the lack of similarities in the clinical situation between man and the animals. The present study has shown that I mai rats spontaneously and invariably develop progressive proteinuria with eventual renal failure.…”

“…Idiopathic focal glomerulosclerosis (FGS) is a fre quent renal disease with poor prognosis [1], Many factors have been implicated in the pathogenesis of FGS, such as glomerular hyperfiltration, coagulative process, abnor mal mesangial handling of macromolecules, and glomer ular epithelial cell injury [2]. Recent studies have shown that hyperlipidemia, which accompanies not only ne phrotic syndrome but also renal diseases of diverse etiol ogy, may contribute to the progressive renal injury in FGS (and in other renal diseases) as an independent factor [3][4][5].…”

Primary Focal Segmental Glomerulosclerosis. Clinical Course, Predictors of Renal Outcome and Treatment.

“…The majority of patients with FSGS manifests nephrotic syndrome, while the minority shows mild to moderate proteinuria. Hematuria, hypertension and renal insufficiency are often seen at presentation (1,2). Since the initial description ofFSGS in 1957 by Rich (3), FSGS is generally believed to be steroid resistant, to have persistent nephrotic syndrome(refractory nephrotic syndrome), and to carry a poor prognosis (4).…”

Correlation between Tubulointerstitial Nephropathy and Glomerular Lesions Induced by Adriamycin

“…Thus, the observation of focal tubulointerstitial changes in the renal biopsy also showing minimal glomerular changes should make one suspect possible FSG [15].…”