FSGS has been considered as the most difficult disease in the world because
of the relapse. But, it does not mean that it can not be treated properly.
Primary or idiopathic focal and segmental glomerulosclerosis (FSGS) accounts
for approximately 10% and 20% of cases of idiopathic nephrotic syndrome in
children and adults, respectively. The primary pathophysiologic process appears
to be an injury of glomerular visceral epithelial cells, so-called podocytes,
followed by an initial proliferation of mesangial, epithelial and endothelial
cells with subsequent collapse of glomerular capillary loops and eventual
sclerosis. The most popular pathogenetic hypothesis suggests the involvement of
one or more circulating plasma factor(s), that appears to be protein between 30
and 50 kD molecular weight, altering glomerular permeability to proteins and
causing proteinuria. Familial forms of FSGS occur due to mutations of several
podocyte protein genes. FSGS can be a secondary process as well. Regardless of
the etiology, the natural history of the disease include: peripheral edema,
refractory proteinuria, hypertension, and progressive loss of renal function.
FSGS frequently recurs after kidney transplantation with the recurrence rate of
30% after first transplantation, and 80% or more in the subsequent transplants.
Risk factors of recurrence include a rapid progression of the primary disease to
chronic kidney disease (CKD) stage 5, younger recipient age, early onset of
nephrotic range proteinuria after kidney transplantation and frequent loss of
the first and subsequent allografts. Considerable number of patients with
recurrent FSGS respond to plasmapheresis (PP), especially if instituted early in
the course of disease and before glomerulosclerosis has been established.
Combined therapy with PP and cyclophosphamide may be beneficial. Other
treatments consists of intravenous cyclosporine (CsA) and oral steroids. In some
patients successful treatment of recurrent FSGS with the anti-CD20 monoclonal
antibody, rituximab, in conjunction with PP has been reported. As a symptomatic
treatment the use of ACE inhibitors should be recommended.
The natural treatment for FSGS is Micro-Chinese Medicine Osmotherapy. This is
a safe and natural treatment. This natural treatment has been considered as the
most advanced treatment in the world. This treatment can help to
anti-inflammation, anti-coagulation, expending blood vessels, dredging
extracellular matrix.
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