2015年10月29日星期四

Prognosis of Focal Segmental Glomerulosclerosis (FSGS)

FSGS stands for Focal Segmental Glomerulosclerosis. It refers to the scarring of the kidneys. FSGS is not an easy disease to treat. If left untreated effectively, most patients with FSGS will eventually develop End Stage Renal Failure and require dialysis or kidney transplant. In most cases, the prognosis of FSGS is poor and the patients will develop End Stage Renal Failure in a few years after diagnosis. At present, FSGS accounts for up to approximately 20% of diagnosis patients. Therefore, it is very important for the patients with FSGS to receive proper treatment to improve the prognosis of FSGS.

Generally, the patients with FSGS are mainly on medication that reduces the amount of protein in urine. These medications are called ACE-inhibitors and ARBs. Moreover, the patients should also receive routine cholesterol treatment to prevent blood clots.

However, these medications for clinical symptoms can not treat the root cause of FSGS at all. Therefore, it can not improve the prognosis of FSGS fundamentally.
In the advanced stage of FSGS, Kidney Transplant is necessary for the patients. However, the disease is very prone to come back after the transplant. The risk of FSGS returning in the transplanted kidney varies from 20~50%. Usually, a return of FSGS in the transplant occurs very soon after the surgery. Therefore, kidney transplant is generally not recommended to the patients with FSGS.

In FSGS, autoimmunity plays the main role in its incidence. The hypersensitive reaction due to the immune complexes in glomeruli is the underlying cause of FSGS. Immunotherapy has showed its unique effect in improving its prognosis and revering the kidneys function.

On one hand, the immunotherapy can suppress the hypersensitive reaction so as to stop further damage to kidneys. Moreover, the application of Chinese herbal medicines can clear up the immune complexes. In this way, it will eliminate the inducement of abnormal immune response.

On the other hand, Immunotherapy can differentiate into new renal functional cells to restore the totally sclerotic glomeruli. Also they also can release some growth agents to stimulate the self-repairing of the impaired glomeruli. In this way, the kidneys will improve and even recover their normal function.


Once the renal function is reversed, the patients will be able to avoid End Stage Renal Failure and improve the prognosis of FSGS dramatically.

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