Epidemiology
Most common cause of nephrotic syndrome in adults, especially in African American and Hispanic populations
Etiology
- HIV (HIV-associated nephropathy)
- Heroin use
- Sickle cell disease
- Massive obesity
- Pamidronate, interferon treatment
Pathophysiology
Injury to podocytes leads to effacement of foot processes and subsequent sclerosis and hyalinosis.
Clinical features
Diagnostics
- LM: segmental sclerosis and hyalinosis
- EM: effacement of podocyte foot processes (similar to minimal change disease)
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