Focal segmental glomerulosclerosis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Initial lab-work up should be directed first towards finding a possible etiology for FSGS. HIV testing in patients with new-onset FSGS, especially those with collapsing variant, is a must in all patient. Additionally, monitoring of disease progression by serum creatinine and proteinuria is equally important.

Work-Up

Blood Work-Up

A comprehensive lab work-up is necessary for all patients with FSGS. Common causes of secondary FSGS, such as HIV, HBV, HCV, and systemic lupus erythematosus (SLE), should also be ruled out:

• Complete blood count (CBC)
• Serum electrolytes
• Serum albumin
• Lipid profile
• Serum creatinine
• Blood urea nitrogen (BUN)
• CD4 count and HIV test (necessary for all patients with FSGS, especially collapsing variant)
• DNA/PCR for parvovirus B19
• CMV test
• Serum complement C3 and C4
• ANA profile
• Titers of antibodies specific for systemic diseases, such as anti-dsDNA
• c-ANCA and p-ANCA
• Serum protein electrophoresis

• Other necessary tests to rule out secondary etiologies, as suggested by history and physical exam

Urinalysis

• Urinalysis with microalbuminuria and urinary creatinine
• Urine culture
• Urinary protein electrophoresis

Laboratory Findings

Blood

• Anemia
• Hypoalbuminemia
• Abnormal lipid profile
• Increased serum creatinine

Urine

• Proteinuria
• No/microscopic/macroscopic hematuria
• Dysmorphic red blood cells
• Fatty casts