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FSGS is the abbreviation of Focal Segmental Glomerulosclerosis which is a kidney problem and mainly involves in glomeruli. It is the leading causes of Nephrotic Syndrome among children and adolescents. Therefore, people with FSGS are running high risk for kidney failure and they need to take some measures to stop the further deterioration of illness.
Diagnosis of FSGS is based on renal biopsy which is an invasive test. In this test, a small piece of kidney tissue is removed from the body for examination. For patients who are diagnosed with FSGS, scars can be found inglomeurli, and also these glomeruli are damaged in the same way. According to clinical studies, involved glomeruli are usually less than 50%. Besides, apart from kidney biopsy, blood test and urine test are also essential for doctors to understand kidney condition well. And these two tests are usually done before kidney biopsy.
Many conditions can cause FSGS like poisoning, low humoral immunity and changes of hemodynamics. Glomerulus works as a filter in kidney. When blood flow through glomerular filtration membrane, wastes and excess fluid are discharged and meanwhile nutrition are preserved. However, when this membrane is damaged, some nutrition like protein will be leaked as well during this process. This is the reason why there are excess proteins in FSGS patients’ urine.
FSGS is not hereditary in many cases, but it is found to have tendency of being familial. Therefore, for people whose parents are living with FSGS, they need to be especial careful about their kidneys.
As we mentioned above, FSGS is the leading cause of Nephrotic Syndrome, so in more than a half of cases, FSGS presents experience foamy urine and swelling which is always associated with weight gain.
Hematuria is another common symptom of FSGS, but microscopic hematuria is more common and microscope is needed for diagnosing this symptom. Only a small group of FSGS patients have gross hematuria, so hematuria is ignored easily by FSGS patients.
Slight elevation of blood pressure is also very common among FSGS patients and it is said about 30% to 50% of patients have high blood pressure.
To tightly control FSGS, many medicines will be involved:
1. Glucocorticoid: prednisone is the most commonly used glucocorticoid in the treatment for FSGS. Illness condition can be brought under control gradually within 3 months, but in many cases, once patients stop taking medicines or reduce medicine dose, illness relapses easily.
2. Cyclosporin A: Application of cyclosporine A helps to reduce protein in urine, which is very important for us to slow down the progression of FSGS.
3. Antihypertension medications for high blood pressure. In cases of FSGS, although blood pressure increases due to kidney damages, if not bring into normal range, it will cause further kidney damages and accelerate illness condition. The most commonly used hypotensors for FSGS patients include ACEI (Angiotensin-Coverting Enzyme Inhibitors), ARBs (Angiotenin II Receptor Blockers), direct rennin inhibitors, Diuretics and Beta-blockers and so on.
4. Chinese medicines for kidney damages: FSGS can not be cured, but with right treatment medicines, some kidney damages can be repaired. We know kidney works through a group of kidney intrinsic cells and when damaged kidney cells are repaired successfully, kidney function is improved. Some Chinese medicines have been proven to be able to restore kidney function. Therefore, if you are a patient of FSGS, you can have a try about Chinese medicine.
● Diet plan for FSGS patients differs from case to case. For FSGS patients, if their illness presents as Nephrotic Syndrome, they need to arrange their protein intake according to their doctor’s suggestions. For some patients, due to serious protein leakage, they run very high risk for hypoproteinemia. Protein is a basic for a healthy body. Low protein level in the body will impair our immunity and make us be susceptible to infections. Therefore, in such a case, they need to increase protein intake slight, and meanwhile try to eat some high quality protein like egg white, lean meat, milk and fish and so on. However, for some patients, high protein intake will increase kidney burden, which is not helpful for them to get recovery and in that case, they need to limit protein intake, so as to avoid further kidney damages.
● For FSGS patients with swelling and high blood pressure, a low-salt diet is very necessary. And also they need to limit fluid intake, including soup, so as to avoid worsening swelling.
● Pay attention to potassium level in blood and try to stay far away from high potassium foods like banana and spinach if lab tests show high levels of potassium in the body.
● High-calcium diet: when FSGS develops to late stage, phosphorus level in blood will increase and this always affects our body from absorbing enough calcium. Under such a condition, high phosphorus foods need to be avoided and high calcium foods are needed.
Prognosis of FSGS can be affected by many factors. In general, to have a better prognosis, the following measures are needed:
1. Prompt diagnosis: FSGS in early stage can be brought under control easily, compared with FSGS in advanced stage, so a prompt diagnosis is very important for FSGS patients to have a better prognosis.
2. Tight control of all the symptoms: Although many symptoms such as high blood pressure and proteinuria due to impaired kidney function, they in turn accelerate illness progression. Therefore, tight control of all the symptoms is also necessary for a better prognosis.
3. Right treatment method: In some cases, FSGS patients are treated by being prescribed with medicines that only helps to control symptoms. Although we need to control all the symptoms very well, it is not the all that we can do. To stop FSGS from developing, we also need to protect residual kidney function and meanwhile repair injured kidney intrinsic cells.
4. Reasonable diet: A well-plan diet is also necessary. What FSGS patients can eat and can not eat depends on their specific illness condition.
Healthy living habits such as no drinking and no smoking.