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Focal segmental glomerulosclerosis (FSGS) is a serious kidney disease that is the primary cause of End-Stage Renal Disease in the United States. The condition is characterized by a common mechanism of injury, known as podocytopathy, which can present in different clinical manifestations. Unfortunately, there are currently no descriptive studies on FSGS available in Mexico.
For five years, from June 2017 to May 2022, a descriptive cross-sectional study was conducted on 229 patients who underwent renal biopsy. The histopathological reports were performed in the Department of Pathology of the National Medical Center of the West and collected for analysis.
According to the data, 229 patients were diagnosed with FSGS, which is known to be the leading cause of glomerular disease. Of these patients, 94 (41%) had a primary cause identified, while the remaining 135 (59%) were classified as having a secondary cause. Interestingly, the age of presentation in the primary cause group was 18 years, significantly lower than in the secondary cause group, which was 29 years.
In terms of gender, primary causes were more common in men (46%) than in women (35%), whereas secondary causes showed comparable percentages between the two genders (49% in women vs. 51% in men). At the time of biopsy, creatinine levels were 0.55 mg/dl in primary causes and 1.4 mg/dl in secondary causes.
The amount of protein in the urine was much higher in primary causes (10.4 grams) compared to secondary causes (2.2 grams). The most common cause, both in primary and secondary cases, was the Non-Specific variety, accounting for 69% and 64%, respectively. Interestingly, only one case of Collapsing Focal and Segmental Glomerulosclerosis was identified. In primary causes, Interstitial Fibrosis and Tubular Atrophy (IFTA) grade 1 was more common, while in secondary causes, grade 2 was more prevalent.
“We cannot simply identify FSGS as a specific disease when it appears as a histological lesion. It is imperative to take a comprehensive approach that considers all possible causes, as FSGS is the leading cause of glomerular disease in the Mexican population."