Controlling proteinuria in secondary focal segmental glomerulosclerosis with cyclosporine: A case report

Focal segmental glomerulosclerosis is a histopathological condition characterized by podocyte injury, which manifests as persistent proteinuria and progressive decline in renal function. It is classified into primary and secondary forms, with secondary focal segmental glomerulosclerosis often resulting from factors such as obesity, hypertension, or genetic mutations. The management of secondary focal segmental glomerulosclerosis remains challenging due to the lack of standardized therapeutic guidelines. This case report describes a 21-year-old male diagnosed with biopsy-proven secondary focal segmental glomerulosclerosis, likely due to obesity-related hyperfiltration, who exhibited significant improvement in proteinuria following cyclosporine therapy. Despite initial treatment with renin-angiotensin system inhibitors and prednisone, the patient continued to have persistent proteinuria. Low-dose cyclosporine therapy was introduced, leading to a marked reduction in proteinuria without deterioration in renal function. This case highlights the potential role of cyclosporine in the management of secondary focal segmental glomerulosclerosis, particularly in cases with suspected genetic predisposition. Further research is needed to determine the long-term efficacy and safety of cyclosporine in secondary focal segmental glomerulosclerosis management.