How is pathogenesis of focal segmental glomerulosclerosis?

➢Injury to podocytes is thought to represent the initiating event of primary FSGS. However, what causes this injury remains unknown. ➢FSGS and minimal-change disease are part of a continuum and that minimalchange disease may transform into FSGS, ➢It is important to distinguish FSGS from minimal-change disease, because the clinical courses and responses to therapy are markedly different. ➢Both are associated with nephrotic syndrome, but the incidence of hematuria and hypertension is higher in individuals with FSGS. ➢unlike minimal change disease, FSGS-associated proteinuria is nonselective, and in general the response to corticosteroid therapy is poor. ➢At least 50% of patients with FSGS develop end-stage renal disease within 10 years of diagnosis.