Focal segmental glomerulosclerosis classification

Focal segmental glomerulosclerosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Focal segmental glomerulosclerosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X-Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Focal segmental glomerulosclerosis classification On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Focal segmental glomerulosclerosis classification All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Focal segmental glomerulosclerosis classification
CDC on Focal segmental glomerulosclerosis classification
Focal segmental glomerulosclerosis classification in the news
Blogs on Focal segmental glomerulosclerosis classification
Directions to Hospitals Treating Focal segmental glomerulosclerosis
Risk calculators and risk factors for Focal segmental glomerulosclerosis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor-In-Chief:’’’ Olufunmilola Olubukola M.D.[3]

Classification

Based on the proposed Columbia classification by D’Agati and colleagues in 2004, the classification of focal segmental glomerulosclerosis (FSGS) based on the morphology is as follows:

Pathological Classification of Focal Segmental Glomerulosclerosis

Variant	Location of Lesion	Distribution of Lesion	Characteristic Features
Not Otherwise Specified (NOS)	Anywhere	Segmental	Capillary lumen abolished by the segmental increase in matrix.
Perihilar Variant	Perihilar	Segmental	Presence of one or more glomeruli containing hyalinosis in the perihilar regions with or without sclerosis. Within each glomerulus, the segmental lesions must contain > 50% perihilar hyalinosis and/or sclerosis.
Cellular Variant	Anywhere	Segmental	Presence of one or more glomerulus with segmental hypercellularity of the capillary endothelium that blocks the capillary lumen, with or without foam cells and/or karryohexis.
Tip Variant	At tip domain	Segmental	One or more segmental lesions, that include tip domains. Lesions must have adhesions/confluence of podocytes with parietal or tubular cells. Tip domains are defined as 25% of tuft adjacent to the origin of the proximal tubule. Sclerosing lesions shuld be <25% of tuft, while cellular lesions should be < 50% of tuft. No perihilar sclerosis should be observed.
Collapsing Variant	Anywhere	Segmental or global	One or more glomeruli with collapse with evidence of podocyte hypertrophy and hyperplasia.

^{Adapted from D’Agati VD, Fogo AB, Bruijn JA, and Jennette JC. Pathological classification of focal segmental glomerulosclerosis. A working proposal. Am J of Kidney Dis. 2004; 43(2):368-382.}