Focal segmental glomerulosclerosis (FSGS) is not a single disease but a histologic pattern of renal damage that initially affects the glomerulus and its tubulointerstitium. FSGS is a leading cause of nephrotic syndrome worldwide and may be found in up to 35% of nephrotic individuals.
What causes glomerulosclerosis?
Glomerulosclerosis is not caused by a single disease. It has several different causes. The scarring may be the result of an infection, or drug toxicity, or a disease that affects the entire body, like diabetes, HIV infection, sickle cell disease or lupus disease. Sometimes, there is no apparent associated disease or cause. There may be a genetic component in some people.
What tests do I need?
A blood test, urine tests, and a kidney biopsy will determine if you have glomerulosclerosis.
Blood test: Your kidney function will be evaluated using the glomerular filtration rate (GFR). Your GFR number is calculated from a math equation that considers the results from a blood test that combines your blood creatinine level, your age, gender and race. People with glomerulosclerosis can have a low GFR, as their kidney damage progresses and kidney function decreases.
Urine tests: Your doctors will order urine tests for protein or red blood cells. Having large amounts of protein appearing in the urine (proteinuria) is common in glomerulosclerosis. Blood in the urine is a warning sign of kidney disease.
Biopsy: Having a low GFR and protein in the urine is not proof of glomerulosclerosis, though. Since these are associated with other kidney conditions, a kidney biopsy is needed to diagnose glomerulosclerosis. In this procedure, a needle is used to take a tiny sample of the kidney to examine with a microscope. The diagnosis is made from the signs of scarring seen on the kidney tissue sample.
Glomerulosclerosis can cause nephrotic syndrome. Nephrotic syndrome means very high levels of protein in the urine, low blood protein levels, high cholesterol levels, and swelling.
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