Focal glomerulosclerosis. Extent of involvement related to steroid resistance

Biopsies were done for 27 nephrotic children whose presentations were compatible with minimal lesion nephrotic syndrome. Percentages of glomeruli involved by focal glomerular sclerosis and its subtypes were calculated. The presence or absence of interstitial disease was noted. These histologic findings were correlated with steroid responsiveness. All patients who had greater than 5% of glomeruli involved by focal glomerular sclerosis resistant to steroids. Interstitial disease was present in ten of the 27 patients studied; eight of the ten were resistant to steroids. Steroid resistance was found to be associated not with the mere presence of focal glomerular sclerosis but rather with its extent and the presence of interstitial disease.