Diagnosis

For possible focal segmental glomerulosclerosis (FSGS), your healthcare professional reviews your medical history and orders lab tests to see how well your kidneys work. Testing may include:

  • Urine tests. These include a 24-hour urine collection that measures the amount of protein and other substances in the urine.
  • Blood tests. A blood test called glomerular filtration rate measures how well the kidneys are getting rid of waste from the body.
  • Kidney imaging. These tests are used to show kidney shape and size. They might include ultrasound and CT or MRI scans. Nuclear medicine studies also might be used.
  • Kidney biopsy. A biopsy usually involves placing a needle through the skin to take a tiny sample from the kidney. The results of the biopsy can confirm a diagnosis of FSGS.

Treatment

Treatment for focal segmental glomerulosclerosis (FSGS) depends on the type and the cause.

Medications

Depending on symptoms, medicines to treat FSGS might include:

  • An angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB). These can lower blood pressure and reduce protein in the urine.
  • Medicines to lower cholesterol levels. People with FSGS often have high cholesterol.
  • Medicines to help the body get rid of salt and water, called diuretics. These can improve blood pressure and swelling.
  • Medicines to lower the body's immune response. For primary FSGS, these medicines may stop the immune system from damaging the kidneys. These medicines include corticosteroids. They can have serious side effects, so they're used with caution.

FSGS is a disease that may return. Because scarring in the glomeruli might be lifelong, you need to follow up with your healthcare team is to see how well your kidneys work.

For people who have kidney failure, treatments include dialysis and kidney transplant.

Lifestyle and home remedies

The following lifestyle changes can help keep the kidneys healthier:

  • Don't use medicines that can damage your kidneys. These include some pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDS you can get without a prescription include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
  • Eat a healthy diet. To protect your kidneys and lower your blood pressure, limit salt and protein.
  • Don't smoke. If you need help quitting, talk with a member of your healthcare team.
  • Stay at a healthy weight. Lose weight if you're overweight.
  • Be active on most days. Being active is good for your health. Ask your healthcare team what types of exercise and how much exercise you can do.

Preparing for your appointment

You may start by seeing your primary healthcare professional. Or you may be referred to a specialist in kidney conditions, called a nephrologist.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do before the appointment, such as not drinking or eating before having certain tests. This is called fasting.

Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment, and when they began.
  • Key personal information, including major stresses, recent life changes and family medical history.
  • All medicines, vitamins or other supplements you take, including doses.
  • Questions to ask your healthcare team.

Take a family member or friend along, if possible, to help you remember the information you're given.

For focal segmental glomerulosclerosis (FSGS), some basic questions to ask your healthcare professional include:

  • What's likely causing my symptoms?
  • What are other possible causes for my symptoms?
  • What tests do I need?
  • Is my condition likely to go away or be long-lasting?
  • What are my treatment choices?
  • I have other health conditions. How can I best manage them together?
  • Are there restrictions I need to follow?
  • Should I see a specialist?
  • Are there brochures or other printed material I can have? What websites do you think might be helpful?

Be sure to ask all the questions you have.

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

  • Do your symptoms come and go or do you have them all the time?
  • How severe are your symptoms?
  • What, if anything, seems to make your symptoms better?
  • What, if anything, seems to make your symptoms worse?
By Mayo Clinic Staff