I have a question regarding FSGS. Recently a dear person to me told me that she was diagnosed with MCD when she was 6 years old ( biopsy was taken at that time). Few years later she mentioned that another biopsy was taken which showed FSGS. Ever since she was followed up by nephrologists and was on steroids and in 2010 she was on cellcept until she stopped both steroids and cellcept in 2016. She had testing done and her recent test shows only an elevated ACR of 67 which I’m assuming to be subnephrotic range. All her kidney functions and ultrasounds were normal and so for the past 26 years she has had this condition and kidney function seems fine. My question is what are the chances of her going into ESRD and needing dialysis? I know it is difficult to speculate but given a history of what I’m guessing a stable partial remission FSGS what are the likelyhood of needing dialysis down the road? Do all fsgs patients end up on dialysis? Thank you

Focal and segmental glomerulosclerosis (FSGS) has many different courses and many different presentations. There is not just one clinical course for all patients with FSGS. In fact, minimal change disease (MCD) has often been found to evolve into FSGS when patients are retested with a second kidney biopsy. It is suspected that the first biopsy just missed the areas of FSGS and hence a diagnosis of MCD was made. This is especially true of patients with MCD that is resistant to steroid therapy.

I am unable to offer any prognosis based on the information that you present. The fact that she has made it 26 years already, suggests a pretty good prognosis. Each person with FSGS is unique and has a unique clinical history and a unique prognosis.

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