Focal Glomerulosclerosis

Focal Glomerulosclerosis: Description, Causes and Risk Factors:Hyaline deposits or scarring within the renal glomeruli, a degenerative process occurring in association with renal arteriosclerosis (hardening of the arteries) or diabetes.Focal GlomerulosclerosisGlomerulosclerosis is the term used to describe scarring that occurs within the kidneys in the small balls of tiny blood vessels called the glomeruli. The glomeruli assist the kidneys in filtering urine from the blood.Glomerulosclerosis is not caused by a single disease. It has several different causes. The scarring may be the result of an infection, or drug toxicity, or a disease that affects the entire body, like diabetes, HIV infection, sickle cell disease or lupus disease. Sometimes, there is no apparent associated disease or cause. There may be a genetic component in some people.People with these conditions may develop glomerulosclerosis:
  • Glomerulonephritis, an inflammation of the glomeruli. About 7 to 15% of people with glomeruonephritis (inflammation) develop glomerulosclerosis (scarring).
  • Reflux nephropathy (backward flow of the urine up to the kidney).
  • Kidney-harming chemicals or medicines that damage the glomeruli.
  • Heroin use.
  • HIV.
  • Inherited genetic problems.
  • Obesity.
  • Reflux nephropathy (a condition in which urine flows backward from the bladder to the kidney).
  • Sickle cell disease.
If untreated, about 50 to 70 percent of people with glomerulosclerosis will eventually experience kidney failure. But even if treated, glomerulosclerosis may still progress to kidney failure within six to eight years after the onset of proteinuria. Once kidney failure is reached, people will need dialysis or a kidney transplant to survive.Researchers are trying to answer the many unanswered questions about this disease. They are now better able to explain what happens in the kidney during glomerulosclerosis. New drug treatments are in clinical trials. Genetic and molecular research is making progress in understanding this condition and suggesting how it could be more effectively treated.Symptoms:Early stages of glomerulosclerosis may not cause any symptoms. Your doctor may suspect kidney disease because you develop high blood pressure or show protein in your urine.If very large amounts of protein are lost in the urine, swelling of the ankles and eyelids may occur, because the body retains water (edema). This may also cause rapid weight gain and a make high blood pressure harder to control.If the condition is advanced, the symptoms may be like those of kidney failure. People report fatigue, a poor appetite, headache, itchy skin, shortness of breath and/or nausea.Diagnosis:Diagnosis may include a blood test, urine tests, and a kidney biopsy will determine if you have glomerulosclerosis.
  • Blood test: Your kidney function will be evaluated using the glomerular filtration rate (GFR). Your GFR number is calculated from a math equation that considers the results from a blood test that combines your blood creatinine level, your age, gender and race. People with glomerulosclerosis can have a low GFR, as their kidney damage progresses and kidney function decreases.
  • Urine tests: Your doctors will order urine tests for protein or red blood cells. Having large amounts of protein appearing in the urine (proteinuria) is common in glomerulosclerosis. Blood in the urine is a warning sign of kidney disease.
  • Biopsy: Having a low GFR and protein in the urine is not proof of glomerulosclerosis, though. Since these are associated with other kidney conditions, a kidney biopsy is needed to diagnose glomerulosclerosis. In this procedure, a needle is used to take a tiny sample of the kidney to examine with a microscope. The diagnosis is made from the signs of scarring seen on the kidney tissue sample.
  • Glomerulosclerosis can cause nephrotic syndrome. Nephrotic syndrome means very high levels of protein in the urine, low blood protein levels, high cholesterol levels, and swelling.
Treatment:Specific treatment for glomerulosclerosis will be determined by your physician based on:
  • Your age, overall health, and medical history.
  • Extent of the disease.
  • Your tolerance for specific medications, procedures, or therapies.
  • Expectations for the course of the disease.
  • Your opinion or preference.
The treatments are corticosteroids (often called “steroids”) or other immunosuppressive drugs (such as cyclosporine). These may decrease proteinuria and improve kidney function. Urine is tested for protein frequently during treatment, because having less urinary protein is a sign that the treatment is working.Another important part of treatment is to control blood pressure and blood cholesterol levels, factors that add to the risk of complications from kidney disease. Certain blood pressure medicines called ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are able to reduce the protein loss and blood pressure. Diuretics are medicines that help the body get rid of excess fluid and swelling. These can be used to lower your blood pressure too.Some diet changes may be needed, such as reducing salt and protein in your food choices to lighten the load of wastes on the kidneys.NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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