Focal segmental glomerulosclerosis care at Mayo Clinic

Your Mayo Clinic care team

The large number of kidney specialists (nephrologists) at Mayo Clinic allows providers 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 FSGS is suspected, your health care provider will review your medical history and order lab tests to assess your kidney function. Testing may include:

  • Kidney function testing. Mayo Clinic kidney specialists (nephrologists) may use a variety of tests to measure your kidney function. These include a 24-hour urine collection and a blood test called glomerular filtration rate that measures how well your kidneys are eliminating waste from your body. 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 only a few centers that 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. A biopsy usually involves placing a needle through the skin to take a tiny sample from your kidney. The results of the biopsy can 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 can be challenging. Some people with FSGS also develop nephrotic syndrome, which may affect treatment choice. Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in the urine.

Depending on the type of FSGS you have, your doctor may recommend:

  • An angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB) medication to lower blood pressure and reduce protein in the urine.
  • Medication to lower cholesterol levels. People with FSGS and nephrotic syndrome often have high cholesterol.
  • Diuretic medications to help your body get rid of salt and water, which can improve blood pressure and swelling.
  • Medication to suppress the immune system if you have primary FSGS. These drugs, including corticosteroids, may stop the immune system from attacking the glomeruli and further damaging kidney function. But these medications can have serious side effects, so they're used with caution.
  • Cyclosporine may be used when corticosteroids such as prednisone are not working in people with nephrotic syndrome.

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

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

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 develop 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 more than 15,500 kidney transplants with excellent results.

Advanced diagnosis and treatment

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

Expertise and rankings

Mayo Clinic treats about 100 people each year who have FSGS. 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 FSGS.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

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Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

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March 08, 2023

Focal segmental glomerulosclerosis (FSGS)