FSGS: from pathogenesis to the histological lesion

Area of Science:

• Nephrology
• Pathology
• Renal Medicine

Background:

• Focal and segmental glomerulosclerosis (FSGS) is a complex kidney disease.
• It can represent a histological pattern of injury or a distinct pauci-immune podocytopathy.
• Current understanding acknowledges diverse etiological classes contributing to FSGS lesions.

Purpose of the Study:

• To clarify the dual nature of FSGS terminology.
• To discuss the challenges in precise classification of FSGS lesions.
• To highlight the etiological diversity associated with FSGS.

Main Methods:

• Review of current and past literature on FSGS.
• Analysis of diagnostic criteria and clinical practice.
• Discussion of etiological factors including reactive, genetic, adaptive, proliferative, and inflammatory forms.

Main Results:

• FSGS can describe a morphological pattern or a specific podocytopathy.
• Practical tools for precise FSGS classification are limited.
• Diagnosis relies heavily on the expertise of nephrologists and pathologists.

Conclusions:

• Accurate diagnosis of FSGS requires a multidisciplinary approach.
• Further research may lead to improved classification tools.
• Clinical, serological, and histological expertise is crucial for managing FSGS.