Focal and segmental glomerulosclerosis (FSGS) is one of the most common primary glomerular diseases to terminate in ESRD. A complete remission (CR) confers an excellent long-term prognosis, but the quantitative benefits of partial remissions (PR) have not been defined.
Is FSGS reversible?
The Potential Reversal of FSGS The tubular epithelium has ample regenerative capacity. Thus, after acute kidney injury (AKI), restoration of parenchyma and function is possible.
Can FSGS come back after transplant?
Focal segmental glomerulosclerosis (FSGS) is a common cause of end-stage renal disease and a common pathologic diagnosis of idiopathic nephrotic syndrome (NS), especially in steroid-resistant cases. FSGS is known to recur after kidney transplantation, frequently followed by graft loss.
Can you get a kidney transplant with FSGS?
Primary FSGS has a 30–80% risk of recurrence in kidney transplant, leading to accelerated graft loss. Patients who lose their allograft to recurrent FSGS are usually not retransplanted since the risk of recurrence in the subsequent allograft is approximately 80–100% .
What causes FSGS?
What causes FSGS? FSGS is not caused by a single disease. It can have many different causes. The scarring may happen because of an infection, or drug, or a disease that affects the entire body, like diabetes, HIV infection, sickle cell disease or lupus.
Is FSGS fatal?
It is a scarring disease of the kidney that generally causes excess protein in the urine, nephrotic syndrome, and progressive kidney failure. It is not fatal, as dialysis and transplant would be the treatment of choice for FSGS that progresses to kidney failure.
Are there any spontaneous remissions in primary FSGS?
Spontaneous remissions are rare in primary FSGS patients (<5%, and usually partial remission only). However, even partial remissions have shown to have better long term outcomes when compared to no remission at all. The following are important points to consider when determining the long term renal prognosis in primary FSGS patients:
Which is the best treatment for primary FSGS?
Plasmapheresis works best in transplant patients with recurrent FSGS before the development of segmental scars. Spontaneous remissions are rare in primary FSGS patients (<5%, and usually partial remission only). However, even partial remissions have shown to have better long term outcomes when compared to no remission at all.
What is the prognosis of the collapsing variant of FSGS?
Prognosis of the cellular variant is intermediate between collapsing and a classic FSGS ( 9 ). Although the collapsing variant of FSGS is most often associated with HIV infection, other causes (including idiopathic causes) exist. Of all of the variants, it still carries the worse prognosis.
What is the prognosis of focal segmental glomerulosclerosis?
Focal segmental glomerulosclerosis (FSGS) is a glomerulonephritis with podocyte injury. The renal prognosis of FSGS is relative poor.