What Are The Treatment Options For FSGS

FSGS is the abbreviation of Focal Segmental Glomerulosclerosis and it is one of the most common chronic renal glomerular diseases. Proteinuria or nephrotic syndrome are the main manifestation of FSGS.

Patients can have stable illness conditions if they can achieve complete remission. However in some cases (about 30%-63%), patients’ illness conditions will continue to deteriorate and kidney functions will be gradually lost and they will in the end develop into renal failure.

Timely and proper treatments for FSGS including eliminating underlying causes and risk factors of FSGS, symptomatic diuretics, antihypertensive treatments as well as proper diets can much alleviate proteinuria and nephrotic syndrome, slow and prevent further illness progression.

The following are available treatment options for Focal Segmental Glomerulosclerosis.

1. Glucocorticoid---before patients develop hormonal resistance, prednisone is commonly prescribed drug for FSGS. Usually it takes about 3-4 months to achieve complete clinical remission. If nephrotic syndrome caused by FSGS can not be relieved after 6 months treatment, cyclophosphamide can be added to help increase remission rate, but the total dosage of cyclophosphamide should be less than 12g.

2. Ciclosporin---6 months ciclosporin treatment can reduce proteinuria, but reduction of dosage or stopping taking the medicine often cause relapse, therefore it needs to be taken as long term maintenance treatment.

3. Cytotoxic drugs---cytotoxic treatment can help lower recurrent rate.

4. Plasma exchange and protein adsorption---they can be used to treat recurrent FSGS after kidney transplant. Plasma exchange or protein adsorption can reduce circulating immune factors and temporarily reduce protein leakage in urine.

5. NSAIDs(Non-steroidal anti-inflammatory drugs) and ACEI---they can treat proteinuria and hyperlipoproteinemia. Others like azathioprine, MMF, ARB drugs can be selectively used according to the patient’s specific illness and physical conditions.

6. Chinese medicines---Chinese medicines can be combined with hormone and cytotoxic treatment to greatly enhance the curative effects. Chinese medicines can reduce side effects and complications of hormones and cytotoxic drugs and improve certain kidney functions so as to improve prognosis of FSGS and prolong patients’ life expectancy.