How Does One Get Focal Segmental Glomerulosclerosis?

• 1. What is Focal Segmental Glomerulosclerosis?

  Focal Segmental Glomerulosclerosis (FSGS) is a kind of primary glomerular disease, which is common in children and adult Nephrotic Syndrome. The kidney histologic feature is the occurrence of sclerosing lesions or hyaline change in part of the glomeruli or part of the branches of glomerular capillary loops.

  The focal nature means only part of the glomeruli is involved(the involved glomeruli is less than 50%); the segmental nature means only part of the branches of glomerular capillary loops are involved; glomerulosclerosis refers to the whole glomeruli can be found to have segmental hyaline change or scarring.

  2. Causes of Focal Segmental Glomerulosclerosis

  The pathogenesis of Focal Segmental Glomerulosclerosis is not clear yet. There are only a series of observation and deduction as follows:

  ◆ The excessive intake of macromolecular by mesangium

  It is found that a long-term and large quantity of proteinuria can cause damages of epithelial cells. And it will develop into focal or segmental glomerulosclerosis if the glomerular mesangial cells are overloaded.

  ◆ Haemodynamic changes in glomeruli

  A high pressure in the glomerular capillary loops plays an important role in the onset of this disease.

  ◆ Hyperlipoidemia

  The onset and development of Focal Segmental Glomerulosclerosis has a positive correlation with Hyperlioidemia.

  ◆ The infiltration of mononuclear macrophage in glomeruli

  Mononuclear macrophage can generate various cell factors, and this kind of material will stimulate the proliferation of mesangial cell, thus leading to glomerulosclerosis.

  ◆ Segmental blood coagulation in glomerular capillary loops can make the activated platelet release platelet activation factor, platelet derived growth factor and others, which can cause lesions of mesangium.

  ◆ Plasma factor

  Focal Segmental Glomerulosclerosis will relapse soon after a kidney transplant. And the recurrence rate can be 35%~50%. It is believed by some people that there is a certain plasma factor which can cause the onset of this disease, by increasing the permeability of glomerular capillary loops.

  ◆ Lesions of epithelial cell in visceral layer

  In the occurrence and development of the disease, not only the proliferation of mesangial matrix plays an important role, but also the lesions of epithelial cell can be the root cause of this disease.

  ◆ Genetic factor

  It is reported that Focal Segmental Glomerulosclersis is not common in siblings. However, it is also found that if patients receive a kidney transplant, and the kidney is donated by his relative who has the same Major Histocompatibility Complex(MHC)(a kind of antigen) with him, then after the kidney transplant, the recurrence rate of this disease is 82%. And the recurrence rate will be 53% if the MHC of the relative is not completely the same, while it will be 35% if the kidney donor has no relation with the patients. All these indicate that genetic factors play a role in the onset of this disease.

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• TAG: Focal Segmental Glomerulosclerosis Causes

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