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2015年1月31日星期六

Diagnosis of FSGS in Clinic

The diagnosis of Focal Segmental Glomerulosclerosis (FSGS) mainly depends on the clinical manifestations of patients and the renal biopsy examination result. Having an exact diagnosis of primary disease is the key part of treating Chronic Kidney Disease.
FSGS can invade people of various ages, but children and teenagers are more easy to get it. The average age of getting the disease is 21, and it always happens when people are younger than 40 years old.
The main manifestations in clinic of Focal Segmental Glomerulosclerosis (FSGS) is Nephrotic Syndrome. Patients suffer from mass proteinuria and serious edema. Microscopic hematuria is common, and it always appears when there is obvious proliferation of mesangial cells. About 2/3 of the patients with Focal Segmental Glomerulosclerosis (FSGS) have high blood pressure. In some cases, before getting FSGS, patients can have infection in their upper respiratory tract, and in turn, the infection will aggravate the clinical manifestations of FSGS.
The examination in lab will show red blood cells and non-selectable urinary protein. Urine with dextrose, amino acid, and phosphate will appear, indicating that the function of renal tubules has been damaged to some degree. Besides, the index of serum IgG may decrease. Also, most patients suffer from a progressively decline of kidney function.
Therefore, in clinic, if one has Nephrotic Syndrome, simple proteinuria accompanied with damaged renal tubules, or Nephrotic Syndrome accompanied with Hypertension, hematuria and non-selective proteinuria, especially when those children who are not sensitive to hormone medication, they have much possibility to have Focal Segmental Glomerulosclerosis (FSGS) . However, the definite diagnosis needs to be done with renal biopsy.
The renal biopsy can show the pathological changes exactly. Glomeruli will have focal segmental hyaline changes, and glomeruli which have no pathological changes will have slight proliferation. Sclerosed capillaries in glomeruli will have cohesion with renal capsule. What's more, renal mesenchyme will have focal changes and foam-like cells. In the immune pathology examination, deposition of IgM and C3 appear in the area where there are sclerosed glomeruli.

Many other diseases will have similar pathological changes of tissues with Focal Segmental Glomerulosclerosis (FSGS), including minimal change kidney disease, mesangial proliferative glomerulonephritis, IgA Nephropathy, kidney disease related to heroin, chronic rejection after kidney transplant, etc. Therefore, to have a reliable diagnosis of Focal Segmental Glomerulosclerosis (FSGS), clinical manifestations, pathological changes based on lab examinations, and also the disease history and other related information need to be taken into consideration. To have a better treatment for Chronic Kidney Disease, the primary disease should be treat well at first, so diagnosis should be attached great importance to. If you want to know more about Focal Segmental Glomerulosclerosis (FSGS), you are welcome to talk with the consultant online or leave a message to me.

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