Overview

  • FSGS, the leading glomerular cause of ESRD in the US, is characterized by progressive scarring (also called sclerosis) in small sections of each glomerulus1,2
  • While injury and loss in the small cells of the glomerulus called the podocyte is thought to be the initial driver of FSGS, inflammation is thought to play a key role in disease progression3,4

FSGS occurs slightly more frequently in men and more frequently in African Americans.1,2 Podocyte loss disrupts the filtration barrier of the kidney and allows plasma proteins, including cytokines, to enter the tubules. This leads to tubule-interstitial injury and the production of proinflammatory cytokines/chemokines, which in turn promote damage to tubule epithelial cells and fibrosis.3,4 The resulting scarring disrupts the kidney’s ability to filter blood and can lead to nephrotic syndrome and ESRD.

References
  1. National Kidney Foundation. Focal segmental glomerulosclerosis. https://www.kidney.org/atoz/content/focal. Accessed November 8, 2018.
  2. Rosenberg AZ, Kopp JB. Focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2017;12(3):502-517.
  3. Abbate M, Zoja C, Remuzzi G. How does proteinuria cause progressive renal damage? J Am Soc Nephrol. 2006;17(11):2974-2984.
  4. Reidy K, Kaskel FJ. Pathophysiology of focal segmental glomerulosclerosis. Pediatr Nephrol. 2007;22(3):350-354.