How is Focal segmental glomerulosclerosis diagnosed

How is Focal segmental glomerulosclerosis diagnosed?

A kidney biopsy is required to establish the diagnosis of FSGS. Patients presenting with sustained proteinuria, whether nephrotic (>3 g/day) or subnephrotic, will typically be evaluated for secondary forms of glomerular disease, including screens for systemic illnesses that may have a kidney component.

Hepatitis B and C and HIV should be excluded by serology.

Antinuclear antibody level should be obtained to screen for systemic lupus erythematosus (SLE). Complement C3 levels may be low in membranoproliferative glomerulonephritis, SLE, and postinfectious glomerulonephritis.

In appropriate-age adults, urine and protein electrophoresis and/or serum free light-chain measurements should be obtained to evaluate for paraproteinemias.

Unfortunately, urine or blood biomarkers have not yet been developed and validated to support the diagnosis or prognosis of FSGS in clinical contexts.

Biomarkers are being evaluated, but they must survive validation and independent replication, steps that have repeatedly flummoxed previous promising candidates.

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