Focal segmental glomerulosclerosis
Segmental glomerulosclerosis; Focal sclerosis with hyalinosisFocal segmental glomerulosclerosis is scar tissue in the filtering unit of the kidney. This structure is called the glomerulus. The glomeruli serve as filters that help the body get rid of harmful substances. Each kidney has thousands of glomeruli.
"Focal" means that some of the glomeruli become scarred. Others remain normal. "Segmental" means that only part of an individual glomerulus is damaged.
Causes
The cause of focal segmental glomerulosclerosis is often unknown.
The condition affects both children and adults. It occurs slightly more often in men and boys. It is also more common in African Americans. Focal segmental glomerulosclerosis causes up to a quarter of all cases of nephrotic syndrome.
Nephrotic syndrome
Nephrotic syndrome is a group of symptoms and abnormal test results that include protein in the urine, low blood protein levels in the blood, high ch...
Read Article Now Book Mark ArticleKnown causes include:
- Drugs such as heroin, bisphosphonates, anabolic steroids
- Infection
- Inherited genetic problems
- Obesity
- Reflux nephropathy (a condition in which urine flows backward from the bladder to the kidney)
Reflux nephropathy
Reflux nephropathy is a condition in which the kidneys are damaged by the backward flow of urine into the kidney.
Read Article Now Book Mark Article - Sickle cell disease
Sickle cell disease
Sickle cell disease is a disorder passed down through families. The red blood cells that are normally shaped like a disk take on a sickle or crescen...
Read Article Now Book Mark Article - Some medicines
Symptoms
Symptoms may include:
- Foamy urine (from excess protein in the urine)
- Poor appetite
- Swelling, called generalized edema, from fluids held in the body
Edema
Swelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...
Read Article Now Book Mark Article - Weight gain
Exams and Tests
The health care provider will perform a physical exam. This exam may show tissue swelling (edema) and high blood pressure. Signs of kidney (renal) failure and excess fluid may develop as the condition gets worse.
Tests may include:
- Kidney biopsy
Kidney biopsy
A kidney biopsy is the removal of a small piece of kidney tissue for examination.
Read Article Now Book Mark Article - Kidney function tests (blood and urine)
Kidney function tests
Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:BUN (Blood urea nitrogen) Creatinin...
Read Article Now Book Mark Article - Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
Read Article Now Book Mark Article - Urine microscopy
- Urine protein
Urine protein
The urine protein dipstick test measures the presence of all proteins, including albumin, in a urine sample. Albumin and protein can also be measured...
Read Article Now Book Mark Article
Treatment
Treatments may include:
- Medicines to reduce the body's inflammatory response.
- Medicines to lower blood pressure. Some of these medicines also help reduce the amount of protein that spills into the urine.
- Medicines to get rid of excess fluid (diuretic or "water pill").
- Low sodium diet to reduce swelling and lower blood pressure.
Low sodium diet
You may need to make changes to your diet when you have chronic kidney disease (CKD). These changes may include limiting fluids, eating a low-protei...
Read Article Now Book Mark Article
The goal of treatment is to control the symptoms of nephrotic syndrome and prevent chronic kidney disease or failure. These treatments may include:
Chronic kidney disease or failure
Chronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...
Read Article Now Book Mark Article- Antibiotics to control infections
- Fluid restriction
- Low-fat diet
- Low- or moderate-protein diet
- Vitamin D supplements
Vitamin D
Vitamin D is a fat-soluble vitamin. Fat-soluble vitamins are stored in the body's fatty tissue and liver.
Read Article Now Book Mark Article - Dialysis
- Kidney transplant
Outlook (Prognosis)
A large portion of people with focal or segmental glomerulosclerosis will develop chronic kidney disease or failure.
Possible Complications
Complications may include:
- Chronic kidney disease or failure
- End-stage kidney disease
End-stage kidney disease
End-stage kidney disease (ESKD) is the last stage of long-term (chronic) kidney disease. This is when your kidneys can no longer support your body's...
Read Article Now Book Mark Article - Infection
- Malnutrition
Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
Read Article Now Book Mark Article - Nephrotic syndrome
When to Contact a Medical Professional
Contact your provider if you develop symptoms of this condition, especially if there is:
- Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
Read Article Now Book Mark Article - Pain with urination
Pain with urination
Painful urination is any pain, discomfort, or burning sensation when passing urine.
Read Article Now Book Mark Article - Decreased urine output
Decreased urine output
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...
Read Article Now Book Mark Article
Prevention
No prevention is known.
References
Appel GB, D'Agati VD. Primary and secondary (non-genetic) causes of focal and segmental glomerulosclerosis. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 18.
Radhakrishnan J, Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 113.
Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Primary glomerular disease. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 31.
Review Date: 4/12/2023
Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.