genitourinary disorders
Focal Segmental Glomerulosclerosis
Prognosis for Focal Segmental Glomerulosclerosis
 50% of patients within 10 years; in 20%, Chronic Kidney Disease occurs within 2 years despite treatment and is more likely if patients have significant tubulointerstitial fibrosis. The disorder is more rapidly progressive in adults than in children. The presence of segmental sclerosis consistently at the glomerular pole where the tubule originates (tip lesion) may portend a more favorable response to corticosteroid therapy. Another variant, in which the capillary walls are wrinkled or collapsed (collapsing FSGS, which is typical in association with IV drug abuse or HIV infection), suggests more severe disease and rapid progression to renal failure. Pregnancy may exacerbate FSGS. FSGS may recur after Kidney Transplantation ; proteinuria sometimes returns within hours of transplantation. Of patients whose transplant was for end-stage kidney disease caused by FSGS, about 8 to 30% lose their graft due to recurrent FSGS; risk is highest in young children, patients who are not Black, patients who develop renal failure People who use heroin and develop nephrotic syndrome due to FSGS can experience complete remission if they cease taking heroin early in the disease. 