Focal segmental glomerulosclerosis care at Mayo Clinic

Your Mayo Clinic care team

The large number of kidney specialists (nephrologists) at Mayo Clinic allows doctors to subspecialize in specific aspects of kidney medicine, including glomerular diseases such as focal segmental glomerulosclerosis (FSGS).

Depending on the situation, kidney specialists might work with other specialists to develop the best treatment plan for you.

FSGS diagnosis

If your doctor suspects you have FSGS, your doctor will review your medical history and order lab tests to assess your kidney function.

  • Renal function testing. Mayo Clinic nephrologists may use a variety of tests, including blood tests and a 24-hour urine collection, to accurately measure your kidney function. You might have iothalamate clearance testing, which uses a special contrast dye to show how well your kidneys are filtering. Mayo Clinic is one of the few centers to specialize in iothalamate clearance testing.
  • Kidney imaging. Kidney shape and structure can provide critical information. Depending on the situation, ultrasonography, computed tomography, magnetic resonance imaging and nuclear medicine studies might be used for a diagnostic workup. Mayo Clinic uses state-of-the art imaging technologies.
  • Kidney biopsy. Taking a tiny sample from your kidney using a needle (biopsy) is required to confirm the diagnosis of FSGS. Because of the large number of people treated for kidney diseases, Mayo Clinic has the dedicated Renal Biopsy Laboratory. Having a biopsy performed at Mayo Clinic ensures that it will be done by experienced specialists with an outstanding track record for safety.

FSGS treatment

Successful treatment of FSGS, and the nephrotic syndrome often associated with it, can be challenging. Your doctor may recommend:

  • An angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB) to lower your blood pressure and reduce protein in your urine
  • High cholesterol medication
  • Diuretic medications to help excrete salt and water, which can improve blood pressure and swelling
  • Anticoagulants if you've had a previous blood clot
  • A vitamin D supplement if your vitamin D level is found to be low

Your doctor may also recommend these lifestyle strategies for overall kidney health:

  • Avoiding medications that have the potential to damage your kidneys, for example, some pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Following a healthy, low-sodium, moderate-protein diet to help protect your kidneys and lower your blood pressure
  • Stopping smoking
  • Losing weight if you're overweight
  • Being active on most days

Drugs to suppress your immune system are sometimes offered to people who can tolerate corticosteroids and immunosuppressive drugs, but this approach isn't effective for everyone. These medications also can have serious side effects.

FSGS is a disease that may relapse. Because scarring in the glomeruli may be permanent, follow-up monitoring is important to assess kidney function.

For people who progress to kidney failure, treatment options include:

  • Dialysis. Mayo Clinic offers state-of-the-art dialysis treatment, including the option for in-home dialysis.
  • Kidney transplant. All three Mayo Clinic campuses offer kidney transplants through the Kidney Transplant Program. Mayo Clinic has performed thousands of kidney transplants with excellent results.

Read more about nephrotic syndrome.

Advanced diagnosis and treatment

Mayo Clinic is active in research to better understand FSGS and to test new therapies through the Nephrology Collaborative Group. You may have the opportunity to participate in clinical trials of experimental treatments.

Nov. 02, 2016
References
  1. Focal glomerulosclerosis. National Kidney Foundation. https://www.kidney.org/atoz/content/focal. Accessed Aug. 14, 2016.
  2. Reiser J. Epidemiology, classification, and pathogenesis of focal segmental glomerulosclerosis. http://www.uptodate.com/home. Accessed Aug. 14, 2016.
  3. What is a kidney biopsy? National Kidney Foundation. https://www.kidney.org/atoz/content/kidney-biopsy. Accessed Aug. 14, 2016.
  4. Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. July 15, 2016.
  5. Thomas LF (expert opinion). Mayo Clinic, Scottsdale/Phoenix, Ariz. Sept. 8, 2016.
  6. Scientific Registry of Transplant Recipients. http://www.srtr.org/default.aspx. Accessed Sept. 28, 2016.
  7. AskMayoExpert. Glomerular disease. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  8. Cattran DC, et al. Treatment of primary focal segmental glomerulosclerosis. http://www.uptodate.com/home. Accessed Sept. 28, 2016.