Epidemiology

Most common cause of nephrotic syndrome in adults, especially in African American and Hispanic populations

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Etiology

• Heroin use
• HIV infection
• Sickle cell disease
• Massive obesity
• Interferon treatment
• Congenital malformations (e.g., Charcot-Marie-Tooth syndrome)

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Pathophysiology

Focal segmental glomerulosclerosis: sclerosis of glomeruli → damage and loss of podocytes

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Clinical features

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Diagnostics

• LM: segmental sclerosis and hyalinosis
• EM: effacement of podocyte foot processes (similar to minimal change disease)

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Treatment

• Initial management: supportive therapy including an RAAS inhibitor (i.e., ACEI or ARB).
• Consider immunosuppressive therapy for all patients with nephrotic syndrome due to FSGS.
  • Prednisone

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