The treatment of primary focal segmental glomerulosclerosis

Nephrotic patients with primary focal segmental glomerulosclerosis (FSGS) h ave a poor prognosis with 50% progressing to end stage renal disease (ESRD) over 3 to 8 years. The achievement of a remission in proteinuria has been associated with a significantly improved renal survival as compared to thos e patients not attaining a remission. Unfortunately, spontaneous remissions are rare in FSGS, and the response to therapy has historically been poor. Recent experience with more aggressive immunosuppressive therapy has lead t o an increase in the remission rate for FSGS patients and given rise to opt imism in the treatment of this glomerulopathy.