Complications
Risk is increased by hypertension, hyperlipidaemia, and hypervolaemia produced by nephrotic syndrome. Some underlying conditions, especially obesity, increase cardiovascular risk independently.
Risk of angina and myocardial infarction is increased by hypertension, hyperlipidaemia, and hypervolaemia produced by nephrotic syndrome. Some underlying conditions, especially obesity, increase cardiovascular risk independently.
Principal determinants of a relatively poor renal outcome include more severe renal dysfunction at presentation, higher level of proteinuria, lack of response to initial treatment, the collapsing variant, and enhanced fibrotic changes, such as interstitial fibrosis and glomerulosclerosis, on initial renal biopsy.
Kidney transplantation should be considered for patients with focal segmental glomerulosclerosis (FSGS) and end-stage kidney disease.[64] About 20% to 30% of patients with primary FSGS who receive a kidney transplant may have a recurrence of FSGS in the allograft.[65]
Likely to be a consequence of increased hepatic lipoprotein synthesis and loss of lipid-regulating proteins in urine. Increased low-density lipoprotein and cholesterol is the most common pattern. Lowering lipids may not necessarily be renoprotective but does prevent cardiovascular death. Most patients require statins, although dietary modifications and exercise should also be encouraged.
Highly active antiretroviral therapy used in the treatment of HIV-induced FSGS produces hyperlipidaemia as an adverse effect.
Developed as a consequence of chronic renal disease. Maintaining blood pressure at 125/75 or less using ACE inhibitors or angiotensin-II receptor antagonists is one of the mainstays of focal segmental glomerulosclerosis management.
Use of this content is subject to our disclaimer