Focal Segmental Glomerulosclerosis: Difference between revisions
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== Medications == | == Medications == | ||
The goals of pharmacotherapy are to preserve renal function, reduce morbidity, and to prevent complications.3 Patients with FSGS should be treated with angiotensin inhibition, an ACE inhibitor or an angiotensin II receptor blocker in order to help decrease protein loss and blood pressure.4 Patients with nephrotic syndrome should be treated with a statin. The primary disorder should be treated in patients with secondary FSGS. A trial of immunosuppressive therapy, corticosteroids and sometimes cytotoxic drugs, is indicated in idiopathic FSGS if proteinuria reaches the nephrotic range or if renal dysfunction is present.4 | |||
== Diagnostic Tests/Lab Tests/Lab Values == | == Diagnostic Tests/Lab Tests/Lab Values == | ||
Revision as of 03:35, 31 March 2011
Original Editors - Jessie O'Donley from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
Focal Segmental Glomerulosclerosis (FSGS) is a kidney disease that involves the formation of scar tissue in the glomeruli. “Sclerosis” meaning scarring and “glomerulo-” which are tiny filters that filter circulating blood producing urine as an end-product.1 When these filters are damaged they become scarred and are no longer able to filter blood appropriately.2 “Focal” meaning that only some of the filters are damaged while some are normal and “segmental” is included because often only parts of the filters are scarred.2
Glomerular damage produces two types of syndromes: the nephrotic syndrome and the nephritic syndrome.1 The nephrotic syndrome is not a specific kidney disease rather it occurs as a result of any disease that causes damage to the kidney-filtering units.1 Nephrotic syndrome is commonly associated with proteinuria, protein in the urine, which occurs in diseases such as diabetes, amyloidosis, and membranous glomerulopathy.1 FSGS is a nephrotic syndrome due to massive amounts of protein found in the urine. The nephritic syndrome is commonly associated with hematuria, blood in the urine, which occurs in diseases such as lupus nephritis, immunoglobulin A (IgA) nephropathy, and acute diffuse proliferative glomerulonephritis.1
Prevalence[edit | edit source]
Typically, idiopathic FSGS is observed in people the age of 18-45 years, although no age group is free from from the disease. In children, FSGS is found in 7-10% of renal biopsies.3 In adults, the lesion is more common in men and is observed in 20-30% of patients.3 FSGS is 3-7 times higher in young African American males when compared to Caucasian males.3
Characteristics/Clinical Presentation[edit | edit source]
It is possible for there to be no signs or symptoms when in the early stages of FSGS. Typically the first sign that a patient commonly recognizes is edema, especially in the legs, and sudden weight gain.2
Signs and Symptoms: 2,3,4,5
• Massive proteinuria and foamy urine appearance
• Edema, swelling and associated weight gain
• Hypertension
• Renal dysfunction with increased creatinine levels
• Hypoalbuminemia
• Hyperlipidemia
• Microscopic hematuria is occasionally present
• Fatigue
• Poor appetite
• Headache
• Itchy skin
• Shortness of air
• Nausea
Associated Co-morbidities[edit | edit source]
See etiology/causes for a full list of co-morbidities associated with primary and secondary FSGS.
Medications[edit | edit source]
The goals of pharmacotherapy are to preserve renal function, reduce morbidity, and to prevent complications.3 Patients with FSGS should be treated with angiotensin inhibition, an ACE inhibitor or an angiotensin II receptor blocker in order to help decrease protein loss and blood pressure.4 Patients with nephrotic syndrome should be treated with a statin. The primary disorder should be treated in patients with secondary FSGS. A trial of immunosuppressive therapy, corticosteroids and sometimes cytotoxic drugs, is indicated in idiopathic FSGS if proteinuria reaches the nephrotic range or if renal dysfunction is present.4
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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