What are the treatment options for Focal Segmenta (FSGS) glomerulosclerosis?

There is no remedy for the focal segment Glomerosclerosis (FSGS), but appropriate care can keep your kidneys healthy for years. FSGS treatment which includes early diagnosis, personalized treatment and continuous care can give you the best chances of renal health in the long term.

Jump at the main dishes to remember.

FSGS treatment objectives

FSGS treatment helps protect your kidneys and manage symptoms. Although your plan is unique to your condition, conservative management is recommended for all types of FSG. The main objectives of FSG treatment include:

• Stop proteinuria (protein leak in your urine) or lower the amount of protein lost in your urine as much as possible
• Help you manage symptoms to support optimal quality of life as long as possible
• Protect your kidney health to avoid chronic kidney disease or kidney failure
• Slow progression of the FSGS
• Treat the underlying cause of FSG, if we exist

Immunosuppressive drugs

People with primary FSG are generally treated with immunosuppressive drugs to obtain proteinuria remission. These drugs are used to help normalize the response of your immune system and prevent it from attacking your kidneys. Immunosuppressants used to treat FSGs include:

• Corticosteroids: These drugs are the most common first -line therapy to improve proteinuria and kidney health. Examples include prednisone and methylprednisolone.
• Calcineurine inhibitors (CNIS): These drugs are the most common second line therapy for FSG. They are used for cases resistant to steroids or when steroids are not well tolerated. Examples include cyclosporin A and tacrolimus.
• Mycophenolate Mofil (MMF): This medication is used as an alternative when the CNIS is contraindicated or causes side effects in cases resistant to steroids.
• Cyclophosphamide: This stronger immunosuppressant is a form of chemotherapy reserved for cases of difficult FSGS when other options fail.

Other drugs

The following drugs can be used in FSGS treatment when immunosuppressants are inadequate or not tolerated:

• Rituximab: This monoclonal antibody targets B cells. It is used in cases of steroids or FSG relapse.
• Sparsentan: This new non -immunosuppressive drug blocks two paths damaged by the kidneys.
• SGLT2 inhibitors: Originally used for diabetes, these drugs help protect the kidneys and prevent protein leaks. Dapagliflozin is an example.
• Drugs for underlying conditions: When a known disease or condition causes secondary FSGs, drugs are used as necessary to treat and manage the underlying cause of FSG.

Treatments if FSG worsen

If the FSGS worsens, it can progress to a terminal kidney disease (renal failure), in which your kidneys cannot operate normally. This condition is irreversible and requires one of the following treatments:

• Renal dialysis: This treatment eliminates waste and additional liquid that damaged kidneys cannot withdraw from your blood and refer the filtered blood for use in your body.
• Plasmapheresis: This treatment uses a machine to separate and eliminate plasma (the liquid part of your blood) from your blood cells. The damaged plasma is replaced by a healthy plasma of a donor. The treated plasma includes useful substances such as albumin to support kidney health.
• Kidney transplant: A transplant can allow a person with renal failure to live a longer and normal life than dialysis treatment. It is a question of replacing a sick kidney with a healthy kidney of a living or deceased donor.

Support

Support treatments are essential for treating all FSGS types and levels. This type of care is designed to improve your quality of life by treating the symptoms and side effects of therapy. These treatments include:

• Exercise: Regular and moderate activity can help establish and maintain blood pressure and healthy weight. This can also improve your general well-being.
• Regular record: Maintaining scheduled appointments to monitor your kidney function can help your health team identify and resolve any change in your illness. These controls are used to monitor the features of the disease, including renal function, protein levels in urine, blood pressure, cholesterol and side effects of drugs.
• Anticoagulants: These drugs are blood medication that help prevent blood clots.
• Raas inhibitors: These drugs, which include inhibitors of the angiotensin conversion enzyme (ACE) or angiotensin II receptor blockers (ARB), can reduce the amount of protein in the urine and control high blood pressure.
• Statins: These drugs help reduce cholesterol levels that can increase with the FSGS.
• Diuretics: Also called water pills, these drugs help your kidneys release salt and liquid to relieve swelling. They can also help treat hypertension (high blood pressure).
• Lifestyle changes: Depending on your symptoms, your treatment plan may include stopping smoking, additional vitamins and / or a low protein content diet.

Main to remember

• The treatment of the FSGS does not imply a “one size” approach. Your treatment plan depends on the type of present FSGS, your symptoms and features such as your age and other health problems.
• The main FSGS treatment objectives involve reducing symptoms and keeping your kidneys normally as long as possible.
• FSGS treatment generally requires continuous care by a nephrologist (kidney specialist) to monitor the progression of your disease, side effects and other changes that may have an impact on the effect of medical treatments.