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Non-urothelial bladder cancers
Transitional cell carcinoma
Hypospadias and epispadias
Posterior urethral valves
Lower urinary tract infection
Acute tubular necrosis
Renal cortical necrosis
Renal papillary necrosis
IgA nephropathy (NORD)
Rapidly progressive glomerulonephritis
Focal segmental glomerulosclerosis (NORD)
Minimal change disease
Medullary cystic kidney disease
Medullary sponge kidney
Multicystic dysplastic kidney
Polycystic kidney disease
Chronic kidney disease
Renal tubular acidosis
Nephroblastoma (Wilms tumor)
Renal cell carcinoma
Renal artery stenosis
Acid-base disturbances: Pathology review
Congenital renal disorders: Pathology review
Electrolyte disturbances: Pathology review
Kidney stones: Pathology review
Nephritic syndromes: Pathology review
Nephrotic syndromes: Pathology review
Renal and urinary tract masses: Pathology review
Renal failure: Pathology review
Renal tubular acidosis: Pathology review
Renal tubular defects: Pathology review
Urinary incontinence: Pathology review
Urinary tract infections: Pathology review
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Focal Segmental Glomerulosclerosis
Focal segmental glomerulosclerosis, or sometimes focal glomerular sclerosis, or just sometimes FSGS, is a type of kidney disease that affects the kidney’s glomeruli, which is where small molecules are first filtered out of blood and into the urine.
From the name, you have glomerulosclerosis, which indicates sclerosis, or scar tissue, forming in the glomeruli.
Segmental means that only a segment, or part of the glomeruli is affected, and focal means that among all those glomeruli in the kidney, only some are affected.
Those glomeruli that are affected, though, allow proteins to filter through into the urine, and ultimately people with FSGS develop nephrotic syndrome.
But what exactly is nephrotic syndrome? Well usually the glomerulus only lets small molecules, like sodium and water, move from the blood into the kidney nephron, where it eventually makes its way into the urine. But with nephrotic syndromes, the glomeruli are damaged and they become more permeable, so they start letting plasma proteins come across from the blood to the nephron and then into the urine, which causes proteinuria, typically greater than 3.5 grams per day.
An important protein in the blood is albumin, and so when it starts leaving the blood, people get hypoalbuminemia—low albumin in the blood.
With less protein in the blood the oncotic pressure falls, which lowers the overall osmotic pressure, which drives water out of the blood vessels and into the tissues, called edema.
Finally, it’s thought that as a result of either losing albumin or losing some protein or proteins that inhibit the synthesis of lipids, or fat, you get increased levels of lipids in the blood, called hyperlipidemia.
Just like the proteins, these lipids can also get into the urine, causing lipiduria.
And those are the hallmarks of nephrotic syndrome—proteinuria, hypoalbuminemia, edema, hyperlipidemia, and lipiduria.
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