FSGS stands for (Focal Segmental Glomerular Sclerosis) is one of the most common causes of primary glomerular diseases. It may happen in both adults and children. When FSGS collapses, patients are easy to have End Stage Renal Disease (ESRD). As children have a relatively low disease resistant ability, they have a higher mortal rate.
When FSGS collapses, the doctor may recommend dialysis or kidney transplant. The average mortality is above 20% a year for all people on Dialysis. For those with kidney transplant, they may be prone to have a recurrence of FSGS and have to do dialysis again.
However, there is no upper limit on the life expectancy of people on dialysis. Some patients with FSGS can live for decades with kidney failure. There are some factors that appear to influence the life expectancy:
1. Degree of proteinuria
Patients with Nephrotic Syndrome (proteinuria≧3.0 or 3.5 g/day and low plasma albumin concentration) have five-year renal survival rates of 60 to 90 percent, and 10-year renal survival rates of 30 to 55 percent. Massive proteinuria (>10 g/day), when unresponsive to treatment, is associated with an even worse prognosis. Most patients progress to ESRD within five years. In contrast, renal survival is much better in patients without Nephrotic Syndrome, especially when this is associated with normal renal function (over 85 percent renal survival at 10 years).
2. Severity of renal dysfunction
More severe renal dysfunction at presentation is generally associated with worse renal survival. In one series, for example, patients with a plasma creatinine concentration of greater than 1.3 mg/dL, had a significantly decreased 10-year renal survival, which was independent of the degree of proteinuria. Worse renal function (unless it is acute) is generally associated with a greater extent of glomerular sclerosis.
Apart from the two factors, the response of therapies can also influence the mortality of FSGS in children. Here I recommend you to try Immunotherapy. Do you want to know more about it? Contact us!