Master Focal Segmental Glomerulosclerosis with Picmonic for Medicine

Focal segmental glomerulosclerosis (FSGS) is the most common cause of nephrotic syndrome in Hispanics and African Americans. This disease can occur as primary disease but also occurs in association with other conditions including sickle cell disease, HIV infection, interferon therapy and heroin abuse. Microscopically, as the name implies, lesions are characterized by sclerosis of some but not all of the glomeruli, making the inflammation focal as opposed to diffuse. Additionally, the lesions within the glomeruli only affect a section of the capillary making the damage segmental. On light microscopy, the glomeruli that are affected demonstrate segmental sclerosis and hyalinosis while the unaffected glomeruli appear relatively normal. Electron microscopy demonstrates focal damage of visceral epithelial cells, while immunofluorescence staining is usually negative. Clinically, FSGS typically has a high incidence of microscopic hematuria, reduced GFR, hypertension, nonselective proteinuria, and poor response to corticosteroid therapy. This disease has a relatively poor prognosis with many individuals progressing to chronic kidney disease and more than half of the patients developing end-stage kidney disease in 10 years.