Focal segmental glomerulosclerosis (FSGS) is a disease affecting the kidney’s glomeruli. Glomeruli are key in filtering our blood. This disease is a top cause of chronic kidney illness, impacting 1% to 3% of people worldwide. When not treated, it can lead to kidney failure. Luckily, there are treatment paths, including medicines, dialysis, and kidney transplants. Additionally, scientists are looking into stem cell therapy for treating FSGS.
Key Takeaways:
- FSGS is a kidney disease that impacts the glomeruli, which are responsible for filtering blood.
- It is a leading cause of chronic kidney disease and can result in kidney failure.
- Treatment options for FSGS include medication, dialysis, and kidney transplantation.
- Stem cell therapy is being explored as a potential treatment for FSGS.
- Further research is needed to fully understand the benefits of stem cell therapy for FSGS.
Classification and Types of Focal Segmental Glomerulosclerosis
Focal segmental glomerulosclerosis (FSGS) has different forms, such as classic, perihilar, tip lesion, collapsing, and cellular.[1] Identifying the specific type helps with the right treatment.
Doctors also group FSGS by what causes it. The main type comes with no known cause. Genetic FSGS is from specific gene issues. Secondary FSGS comes with conditions like obesity or diabetes. There’s also unspecified FSGS without a clear cause.[2][3][4]
Knowing the types and causes of FSGS is vital. This knowledge lets doctors create targeted treatment plans. This could lead to better outcomes for patients.
Examples of FSGS Classification
Let’s look at two types of FSGS to see the difference:
| Classification | Description |
|---|---|
| Classic FSGS | This form targets the glomeruli in a focal, segmental way. Some parts of the glomeruli show scarring. It is known for adhesions and sclerosis. |
| Collapsing FSGS | This type sees the glomerular capillaries collapse. It means severe podocyte injury and harm to the kidney over time. The outlook is often not good. |
Using features like histology and cause helps in diagnosing FSGS correctly. It also guides the best treatment for each case.
Stay tuned for the next section where we will delve into the symptoms, diagnosis, and treatment options for Focal Segmental Glomerulosclerosis.
References:
- J. R. Sedor and P. F. Barisoni, “Focal Segmental Glomerulosclerosis”, New England Journal of Medicine, vol. 375, no. 22, pp. 2200-2211, 2016.
- N. Korbet, “Treatment of Primary Focal Segmental Glomerulosclerosis”, JASN, vol. 26, no. 6, pp. 1121-1126, 2015.
- D. J. Friedman and N. G. Polinsky, “Genetic Basis of Focal Segmental Glomerulosclerosis”, JASN, vol. 30, no. 7, pp. 1275-1285, 2019.
- R. J. Glassock, “Secondary Causes of Focal Segmental Glomerulosclerosis”, Frontiers in Endocrinology, vol. 10, p. 8, 2019.
Symptoms, Diagnosis, and Treatment of Focal Segmental Glomerulosclerosis
Focal segmental glomerulosclerosis (FSGS) can make your kidneys not work right. It shows through symptoms like:
- Swelling: This disease causes your feet, hands, and ankles to swell with extra fluid.
- Weight gain: The extra fluid because of FSGS can make you gain weight suddenly.
- High blood pressure: FSGS leads to high blood pressure, which is bad for your heart.
- Proteinuria: It means having too much protein in your urine, which can make your urine look foamy.
- Hypoalbuminemia: This illness lowers the albumin protein in your blood, leading to swelling and more fluid in your body.
- High creatinine levels: Your kidneys work less well with FSGS, making creatinine levels in your blood go up.
FSGS is diagnosed through a detailed check-up. The process includes:
- Physical exam: A doctor will look for symptoms, check your blood pressure, and see if you have swelling.
- Testing samples: They take urine and blood to see if you have protein and other signs of FSGS.
- Glomerular filtration rate test: This check-up measures how well your kidneys clean your blood. If it’s low, it might mean FSGS.
- Ultrasound of the kidneys: This scan shows if there are problems with your kidneys.
- Kidney biopsy: The most accurate way to diagnose FSGS. It involves taking a tiny piece of your kidney to look at under a microscope.
After being diagnosed, treating FSGS focuses on slowing it down and easing symptoms. Ways to treat it are:
- Drugs for blood pressure: Taking medicines like ACE inhibitors or ARBs can help control high blood pressure and lessen protein in your urine.
- Corticosteroids: These drugs, like prednisone, are used to fight kidney inflammation and lower protein in the urine.
- Diuretics: They help your body get rid of extra fluid, reducing swelling and relieving edema.
- Immunosuppressants: Medicines such as cyclosporine can be used to calm down your immune system and lessen kidney inflammation.
- Dialysis: If your kidneys fail because of FSGS, you might need dialysis. It’s a way to clean your blood when your kidneys can’t.
- Kidney transplant: For people whose kidneys stop working, a kidney from a donor can be a long-term solution. It replaces the damaged kidney and works normally.
Stem Cell Therapy for Focal Segmental Glomerulosclerosis
Stem cell therapy shows hope for treating Focal Segmental Glomerulosclerosis (FSGS). It uses cells known as Mesenchymal stem cells (MSCs). These cells come from various places like the bone marrow, fat tissue, or blood.
MSCs can help the kidney heal and lessen swelling, which is good news for FSGS patients. This shows how powerful stem cell therapy can be.
Patients who get new kidneys often worry about FSGS coming back. But using MSCs might lower this risk. This improvement could make kidney transplants more successful for these patients.
The good early results are encouraging. But, we need to do more research to understand this therapy fully. This will help us know if it’s the right choice for treating FSGS.