Focal Glomerulosclerosis — A Review
The precise definition of a disease entity is often very difficult, and all we are doing in glomerulonephritis is dividing it up into a number of what we hope are useful categories. It seems to me that the criticisms which have been levelled at the acceptance of focal glomerulosclerosis as an entity, can equally be used to attack a well-accepted category such as membranous glomerulonephritis. It is suggested that focal sclerosing lesions can be produced by different aetiological factors, but this is also true of membranous glomerulonephritis. It has been pointed out that patients with segmental sclerosing lesions do not always have a uniform prognosis and yet we know that 25% of membranous cases may recover spontaneously. It has also been pointed out that focal sclerosing lesions may complicate other patterns of disease. This also applies to the membranous pattern which can be seen in lupus nephritis and superimposed on mesangio-capillary glomerulonephritis. Finally we now have quite good evidence of recurrence of focal glomerulosclerosis in renal transplants, yet this is rare in membranous glomerulonephritis. On this evidence it would seem that focal glomerulosclerosis is at least as reliable an entity as membranous glomerulonephritis. For the purpose of this account I intend to ignore focal global glomerulosclerosis which several workers have shown to have the same prognosis as minimal change disease.
KeywordsLupus Nephritis Aetiological Factor Focal Segmental Glomerulosclerosis Minimal Change Disease Proliferative Glomerulonephritis
Unable to display preview. Download preview PDF.
- 1.Brown CB. Cameron JS. Turner DR. Chantier C. Ogg CS.Google Scholar
- Williams DG. and Béwick M. (1978). Focal segmentalGoogle Scholar
- glomerulosclerosis with rapid decline in renal function (“malignant FSGS”). Clinical Nephrology Vol. 10 p51–61.Google Scholar
- 5.Glasser RJ. Velosa JA. and Michael AF. (1977). Experimental Model of Focal Sclerosis. 1) Relationship to Protein excretion in aminonucleoside nephrosis. Lab. Invest. Vol. 36 p519–526.Google Scholar
- 6.Schoeneman MJ. Bennett B. and Greifer I (1978). The natural history of focal segmental glomerulosclerosis with and without mesangial hypercellularity in children. Clinical Nephrology Vol. 9 p45–54.Google Scholar