Focal segmental glomerulosclerosis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief:’’’ Olufunmilola Olubukola M.D.[2]

Epidemiology & Demographics

Focal segmental glomerulosclerosis (FSGS) is considered the most common cause of nephrotic syndrome worldwide.FSGS remains the most common primary glomerulonephropathy across ethnic and racial distribution in the United States. Data from the United States Renal Data System (USRDS) collected over 21 years shows that FSGS is the most common renal pathology identified in end-stage renal disease (ESRD) patients in the United States.

Incidence and Prevalence

The prevalence of FSGS as a lesion associated with ESRD has risen. In 1980, FSGS was the cause of ESRD in only 0.2 percent of patients; by 2000, it was responsible for 2.3 percent of cases of ESRD. Around the world, there are contrary evidences as to FSGS being the most common cause of Nephrotic Syndrome. Though, FSGS accounts for 15 to 45% of all primary glomerular diseases worldwide, higher incidence and prevalence of FSGS are seen only in America, India, Brazil and Saudi Arabia.
In Asia, Europe and Australia however, IgA nephropathy remains the most common cause of Idiopathic Nephrotic Syndrome accounting for about 40 to 45% cause of primary glomerulopathy while in Africa, MCD is the most common cause of Idiopathic Nephrotic Syndrome accounting for 16.5% of all causes of primary NS.

Age

The disease is considered a disease of the adult population (vs. minimal change disease which is much more common among children). In a 21-year follow-up study that excludes HIV-associated nephropathy, the median age of FSGS ESRD is 40-49 years in black adults and 70-79 in white and Asian adults.

Gender

The male to female ratio is 1.5-2 to 1.

Race

FSGS is the most common primary renal cause of end-stage renal disease (ESRD) in whites and blacks, contributing to approximately 2% of ESRD.

FSGS is more common in blacks. It accounts for approximately 35% of nephrotic syndromes in all cases and approximately 50% of nephrotic syndrome in blacks. FSGS seems to have a higher incidence in Blacks with a familial pattern of inheritance especially in Blacks with family history of ESKD.