Focal Sclerosing Glomerulonephritis

Focal Sclerosing Glomerulonephritis
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Focal sclerosing glomerulonephritis is a kidney disease in which the kidneys' ability to remove excess fluids and waste is damaged. This condition can be chronic (comes on gradually) or acute (sudden inflammation attack). This condition can occur on its own, known as primary glomerulonephritis, or it can be caused by another disease, such as diabetes or lupus, in which it is known as secondary glomerulonephritis. This disease is characterized by focal areas of glomerular tissue thickening and hardening that often beginning in the juxtamedullary gomeruli and spreading gradually to other parts of the kidney. Eventually, this condition results in kidney failure.

Symptoms of This Disease

Patients often experience two sets of symptoms: beginning symptoms and additional symptoms as this disease progresses. The beginning symptoms include weakness and fatigue, loss of appetite, low blood protein levels with high urine protein levels, foamy urine, increased weight due to retaining fluid, and swelling around the hands, abdomen, eyes, and feet.

As this disease progresses patients may experience other more serious symptoms, such as a higher risk of blood clots, malnourishment, abnormally high or abnormally low blood pressure, muscle wasting due to protein loss, weakening of the bones, high levels of cholesterol in the blood, an increased vulnerability to infectious disease due to immune system impairment, and kidney failure.

Diagnosing This Disease

Diagnosis is often made by a kidney specialist, also referred to as a nephrologist. Blood and urine samples are often taken and if these show decreased protein amounts in the blood and increased protein amounts in the urine, a kidney biopsy may be ordered. The nephrologist may also recommend that the kidneys be looked at through ultrasound scanning.

Treating This Disease

Primarily, treatment will revolve around treating the underlying cause and some of the symptoms of help keep the patient comfortable. Corticosteroids, such as prednisone, are often prescribed to patients. These are often administered for several weeks at a time. Alternative therapies may be effective, particularly for patients who do not respond well to corticosteroids and cytotoxic drugs. Some common alternative therapies include ACE inhibitors, azathioprine, thioguanine, mycophenolate mofetil, and levamisole.

Medications to treat the underlying condition may also be prescribed. Patients may also be prescribed medication to lower their cholesterol and blood pressure if these are an issue for them. Diuretics may be prescribed to patients with fluid retention, in addition to a restricted fluid intake. A special diet with regular exercise may also be beneficial for some patients.

Those who are experiencing kidney failure due to focal sclerosing glomerulonephritis may undergo kidney dialysis. This treatment method will help to artificially replace lost kidney function. This will help the kidneys flush out what is building up in them, such as excess protein.

Resources

Southern Cross Medical Library. (2007). Nephrotic Syndrome. Retrieved on February 28, 2010 from the Southern Cross Medical Library: https://www.southerncross.co.nz/AboutTheGroup/HealthResources/MedicalLibrary/tabid/178/vw/1/ItemID/137/Nephrotic-Syndrome.aspx

Merck Manuals Online Medical Library. (2005). Nephrotic Syndrome. Retrieved on February 28, 2010 from Merck Manuals Medical Library: https://www.merck.com/mmpe/sec17/ch235/ch235c.html#sec17-ch235-ch235c-879

Image Credits

Kidney: United States Federal Government – Wikimedia Commons