According to Rao (1), focal segmental glomerulosclerosis (FSGS) is normally the formation of scar tissue in kidney parts. He points out that the term FSGS is normally deployed in describing the type of a rare disease, which normally attacks the tiny kidney filtering systems, thereby causing strenuous scarring. It damages the glomeruli arising from the leakages of proteins and other harmful substances into the urine thereby resulting into a condition known as proteinuria (Rao, 1). It is this condition of proteinuria that causes the accumulation of these harmful fluids in the body. When prolonged leakage occurs, it not only damages the kidney, but also causes its failure.
Onset, Diagnosis, Treatment, and Expected Outcome of FSGS
Rao (1) notes that FSGS normally affects both children and adults. However, it is the males, who are mostly affected by the disease as compared to their female counterparts. Rao notes that this condition is normally believed to be caused by HIV infections or the use of drugs such as heroine. He further points out that FSGS is frequently encountered among patients, who suffer from diabetes, obesity or sickle cell disease. The condition can also be caused by reflux nephropathy, a situation where the urine is forced to flow backward to the kidney from the bladder.
Agati, Kaskel and Falk (1) point out that the onset of the focal segmental glomerulosclerosis may be captured, based on the symptomatic signs. They note that the disease normally shows no symptoms on the affected patients at its early stages. However, as it progresses, some symptoms normally start showing up. The two scholars note that those who suffer from FSGS normally encounter the swelling of parts of the bodies especially in their ankles, hands, and around their eyes. This condition is referred to as edema and normally occurs due to the accumulation of large volumes of proteins in the body. It is identified by the spillage of large amounts of proteins in the urine, high blood pressure, low blood protein, and existence of high level of cholesterol in the blood as well as other symptoms of the condition.
As pointed out by Agati, Kaskel and Falk (1), ignoring early diagnosis of patients with focal segmental glomerulosclerosis condition can gradually result into kidney failure, a condition referred to as en-stage renal disease (ESRD). They note that it may take the patients a period of between one year and a decade to reach the ESRD. Therefore, it is important for the affected patients to seek immediate treatment. Agati, Kaskel and Falk point out that those patients who have been diagnosed with the condition and are at the stage of ESRD must undergo dialysis and kidney transplant treatments. Dialysis allows their blood to be cleansed through removal of accumulated harmful fluid that can adversely affect their kidney functionality, while kidney transplant allows their affected kidney to be replaced with non affected one. This improves the effectiveness of the patient’s blood filtering system.
On the other hand, Appel and Cattran (1) note that FSGS patients can be treated by immunosuppressant drugs such as cyclosporine. The drugs help reduce their immune response allowing them to stop proteinuria. They add that most doctors normally prescribe blood pressure medicines known as ACE inhibitors to patients in order to control the progression of kidney failure due to the effect of FSGS. They point out that treating a patient with proteinuria condition, of more that of 3.5g/day, with immunosuppressive agents normally results into a reduction of more than 50 percent of proteinuria in the body. Some doctors normally advice their patients to take diets, which are of low protein and cholesterol contents. Therefore, failure to control the FSGS condition may results in chronic kidney failure, end-stage kidney disease, nephritic syndrome, as well as malnutrition and infection.
FSGS Laboratory Tests
According to Agati, Kaskel and Falk (1), kidney biopsy, urinalysis, urine protein and kidney functions tests can be conducted in the laboratory if determining whether a patient has FSGS. They note that kidney biopsy normally requires doctors to use specialized biopsy needles in removing tiny samples of the kidney, which are then examined by means of a microscope and then the results are analyzed. In case the examined kidney tissue does not show the normal structure, which indicates unexplained drop in kidney function, then the doctor can denote such factor to the presence of protein in the urine.
Urinalysis on the other hand is the laboratory testing and measuring of the various components of the elements that pass through the urine. Agati, Kaskel and Falk (1) note that by determining the urine specific gravity, which is the concentration of all chemical particles found in the urine, a doctor is able to detect patient’s liability to FSGS. They point out that under microscopic examination, urine color should be tested to ascertain that it conforms to the normal color that ranges from colorless to dark yellow. According to them, the chemical component of the urine should also be tested against the normal urine specific gravity of 1.002 to 1.030. They note that any results that are higher or below the specified range may denote severe kidney infection, diabetes or excessive fluid intake. They, however, warn that lab technicians should be aware of drugs, such as dextran and sucrose, which can easily increase the specific gravity measurement, thereby providing inaccurate results.
In conclusion, focal segmental glomerulosclerosis is a serious chronic disease which if not effectively addressed in time can cause kidney failure. The paper has also pointed out the need for doctors to offer effective laboratory tests and sufficient medical procedure thereafter to patients, who show signs of the disease. Moreover, proper diet, which is low in protein and cholesterol contents, should be encouraged to help in reducing the impact of the FSGS condition.