Primary and Secondary (Non-Genetic) Causes of Focal and Segmental Glomerulosclerosis

In this article of Primary and Secondary (Non-Genetic) Causes of 

Focal and Segmental Glomerulosclerosis i will be giving you an exact 

detail on how on FSGS and the causes for both Primary and Secondary 

non-genetic . Coming to FSGO it is a term for a specific section of 

damage to the kidney as well known kidneys are two-bean shaped 

organs in the body, one on each side of our body just below to the 

ribcage in the back.


We face FSGS only when the filters of our kidneys are damaged 

which can lead to damage of our and kidney. Still being the rarest 

kidney disease but early precautions and good treatment in case will 

help you to recover.     

Table Of Contents          

  • Pathophysiology of FSGS
  • Risk Factors and Causes 
  • Clinical Features
  • Treatment and Medicines 
  • Prevention
  • Prognosis and natural course of disease
  • Conclusion


Pathophysiology of FSGS  


Well to differentiate we have to FSGO terms one is primary Focal and

Segmental Glomerulosclerosis and Secondary Focal and SegmentaL

Glomerulosclerosis . 

Primary FSGS is an injury which is within the podocytes. The early

stages is foot process effacement, proliferation, endothelial and in the

end epithelial cells during the early stages, which later on is followed by

the shrinkage of glomerular capillaries which lead to glomerulosclerosis

also known as scarring.


Well this process can be shown up in different forms of the kidney,

ranging from normal unaffected glomerulus to certain segmental

sclerosis and then global glomerulosclerosis as the disease spreads on

a progressive rate. 


This different form can be described as FSGS, Perihilar FSGS, Cellular

FSGS and Tip FSGS and Collapsing FSGS. Where one can describe

Perihilar FSGS as one glomerulus with perihilar hyalinosis with more

than 50% glomeruli within the glomerular vascular pole. Cellular FSGS

are basically known as 1 glomerulus with endocapillary

hypercellularity at least 25% of the tuft and causing occlusion of the



Tip Fsgs is a localized sclerotic lesion limited to the tubular pole of the      Glomerulus. Collapsing FSGS are at least on glomerulus displaying


Secondary FSGS is caused by another disease or a drug, which include viruses such as HIV or drugs . Drugs like anabolic steroids that some people use to boost their muscle growth.


This also brings under a conclusion that Secondary FSGS has less severe clinical features compared to primary one,It creates a variety of renal diseases that progress to ESRD through the form of Secondary FSGS.


Risk Factors and Causes

Risks Factors of developing FSGS are given down below:

  • African American
  • Above the age of 45
  • A Family Member with the gene defect that causes FSGS 


So if any you have points which are above then a consultation on a Primary FSGS scale.


On a secondary FSGS you can also face which include down below:

  • Diseases include sickle cell anemia
  • Drugs as heroin or anabolic steroids 
  • Obese 
  • Infection


Causes of FSGS are diabetes, sickle cell disease other kidney diseases and obese. It can also have high levels of drug toxicity and also infection . 


Clinical Features 


Primary FSGS is a common cause of nephrotic syndrome in Adults and accounts  for about 4% end- stage renal disease(ESRD). FSGS frequently manifests as syndrome but is less responsive to steroid therapy for certain reasons. 


Some patients with FSGS will gradually get worse until at some point it will reach kidney failure. If it occurs then an immediate kidney transplant is necessary. Some people will have a sign of change in the process of treating it wisely.


Treatment and Medicines 


FSGS is challenging but there is best possible hope to reconcile it with proper medication .Nevertheless FSGS has a Nephrotic syndrome which causes a disorder in your body which allows an escalating rate of protein to be passed into your urine . Down below are some medications which your doctor might prescribe based on the level of FSGS you got-

  • Medication to drain down cholesterol levels.
  • Medication to help your body to get rid of salt and water. 
  • ACE also known as angiotensin converting enzyme medication to lower blood pressure and reduce protein in the urine.
  • If you have primary FSGS then drugs like corticosteroids, will help your body to stop the immune system from attacking the glomeruli but matter of fact is that they also have serious side effects.

Advanced Situation

FSGS is a disease that may counter more problems in your body as the scarring in the glomeruli is permanent, which follows up in the kidney function. Down below are certain Advanced treatments which develop kidney failure-

  • Dialysis– This is a process where waste products and excess fluids from the kidney stops working properly then dialysis helps us divert blood to a machine which then gets to be cleaned. One needle slowly removes blood and then transfers it to a machine called a “dialyser”.
  • Kidney Transplant –  A surgery to place a healthy kidney from a living donor into a person whose kidneys don’t work no more from kidney failure. An average life expectancy for a patient on Kidney transplant is around 12-20 years.



It is good to have a prevention because facing FSGS is also risky to your kidney and is catastrophic. Down below are some tips to help you prevent facing FSGS-

  • Stop smoking. 
  • Lose weight if you’re obese. 
  • Be Active and work out by doing exercises .
  • Have a diet plan most preferably like a low protein diet would do which helps to protect your kidney and lower the blood pressure.
  • Avoid medicines that have the potential to damage your kidney.


Prognosis and natural course of disease


A report says the level of proteinuria has been significant in primary FSGS patients and with non- nephrotic proteinuria have a good extreme good prognosis which stands at <20% progress to ESRD.


Whereas 50>% students with nephrotic range progress to ESRD over 10 years in patients with massive proteinuria >10g/d it is pretty significant resulting in ESRD by 2 years on average.


On an average rate primary FSGS is carried out by nephrotic syndrome in US adults and accounts for about 4% of ESRD which states as End stage renal disease and the lesions are characterized by focal involvement. 


With the context of the above article we can say that Primary FSGS is one of the most common diseases of nephrotic syndrome mostly in adults. Many secondary causes of FSGS must be excluded  and non-nephrotic patients are often found to progress within 5-10 years. But good medication only if the time if you FSGS has spread into the body then immediate medication will do but prevention is always the best way possible to tackle FSGS.

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