Focal segmental glomerulonephritis

Focal segmental glomerulonephritis is the commonest cause of nephrotic syndrome in afro-american adults.

Histologically there are focal areas of sclerosis and on immunofluorescence there is IgM and C3 deposition.

Focal segmental glomerulonephritis may be primary or secondary to:
  • reflux nephropathy
  • obesity
  • Alport's syndrome
  • sickle cell disease
  • HIV
  • heroin use
  • IgA nephropathy

Treatment is:
  • corticosteroids
  • if steroids fail, ? ciclosporin
  • if all fails, kidney transplant
    • but note that focal segmental glomerulonephritis can recur in the transplanted kidney

  • around a third of patients respond to steroid treatment and recover
  • around 50% progress to end-stage renal failure

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