FSGS: Let's learn about a disease that silently damages your kidneys? (Focal Segmental Glomerulosclerosis)

Have you ever thought that the two kidneys inside our body are like a super filtration system? That's exactly what happens. The main job of the kidneys is to filter out the unwanted waste products in our blood and excrete them from the body as urine. But imagine, what if something were to damage this valuable filter? That's when the problems begin. Today we are going to talk about a less-known, but very important condition that damages the filters in the kidneys. That is FSGS.

Simply put, what is FSGS?

The full name for FSGS is Focal Segmental Glomerulosclerosis. While the name may sound a bit complicated, the story is actually quite simple. Let's break it down and understand.

Each of our kidneys has about a million tiny filters that help filter our blood. In medical terms, these are called glomeruli . Think of them as a tea strainer in the kitchen. As blood passes through these filters, they keep the good things the body needs (nutrients, minerals) back into the blood, and filter out the unwanted waste products and excess water. What is separated is what comes out as urine.

In FSGS, these tiny filters (glomeruli) become scarred or hardened. This is called ``sclerosis.'' When this scarring occurs, the filters are unable to do their job properly.

Now let's look at the other words in the name:

• Focal: This means that this damage does not affect all the filters in the kidney, only some of them are affected.
• Segmental: This means that even in damaged filters, only a portion of the filter is damaged, not the entire filter .

What are the main types of FSGS?

FSGS can be divided into three main types. Let's see what they are.

What are the symptoms of someone with FSGS?

The biggest problem with FSGS is that it doesn't have any obvious symptoms in the early stages . It's often discovered incidentally during a routine medical exam or while being tested for another condition. However, there are a few common symptoms.

• Edema: Swelling, especially in the legs, ankles, hands, and face. This is the first symptom many people notice.
• Proteinuria: When the kidney filters are damaged, the proteins that the body needs are filtered out and excreted in the urine. This can cause your urine to appear foamy (like soapy water).
• Increased blood cholesterol levels.
• Decrease in the protein albumin in the blood.
• Sudden weight gain: This is due to unnecessary water retention in the body.
• High blood pressure (Hypertension).

Dangerous conditions (complications) that can occur due to this disease

If FSGS is not properly managed, serious complications can develop over time. The most serious and dangerous complication is kidney failure . This is when the kidneys are unable to function properly. This is a life-threatening emergency.

If you have FSGS and experience the following symptoms, you should go to a hospital's emergency department (ETU) immediately :

• Uncontrollable high blood pressure.
• Blood loss (anemia).
• Nausea, vomiting, and loss of appetite.
• Severe swelling of the hands, feet, and face.

How does a doctor diagnose FSGS?

After listening to your symptoms, the doctor will refer you for several tests.

• Blood tests: Check the levels of protein, waste products, and fats in the blood.
• Urine tests: Measure the amount of protein and blood in the urine.
• Kidney function test (Glomerular Filtration Rate - GFR): This measures how well your kidneys are working.

But while all of these tests can suggest the presence of FSGS, there is one test that must be done to confirm the disease 100% : a kidney biopsy .

What is a kidney biopsy?

This involves taking a very small piece of tissue from your kidney using a small needle. The tissue is then examined under a microscope to see if there is any scarring in the kidney's filters. This is considered the gold standard for diagnosing FSGS.

What are the treatments for FSGS?

Treatment for FSGS varies from patient to patient. It depends on factors such as the type of FSGS you have, your age, and other medical conditions you have. The main goals of treatment are to control symptoms, maintain a good quality of life, and minimize damage to the kidneys and prevent kidney failure.

The doctor may recommend the following treatments:

Types of drugs

• Medicines that control blood pressure and reduce protein excretion in the urine. Examples: `(Angiotensin-converting enzyme inhibitors - ACE-Is)`, `(Angiotensin receptor blockers - ARBs)`.
• Diuretics are drugs that reduce water retention in the body.
• Immunosuppressive drugs are drugs that control the function of the immune system.
• Steroids such as `(Corticosteroids)`.
• In some cases, specialized treatments such as `(Plasmapheresis)`.

Lifestyle changes

Just like medications, changes you make to your lifestyle are also very important.

• Diet: It is very important to limit the amount of salt (sodium) and protein in your diet. Consult your doctor and a nutritionist about this.
• Exercise: Engage in daily exercise.
• Avoid smoking: If you are a smoker, quitting immediately is essential for kidney health.

What does the future hold for someone living with FSGS?

FSGS is a chronic disease with no cure. The prognosis varies from person to person. Some people can live with the disease well-controlled with treatment and have no problems for years. For others, the disease can gradually worsen and lead to kidney failure.

If that happens, you may need dialysis or a kidney transplant to survive.

But whatever the case, with proper treatment, following your doctor's instructions, and maintaining a healthy lifestyle, most people with FSGS can lead active, successful lives. The most important thing is to stay on top of your condition by getting regular medical checkups.