title: Current and emerging treatments for idiopathic focal and segmental glomerulosclerosis in adults.
abstract: Idiopathic focal and segmental glomerular sclerosis is a frequent cause of nephrotic syndrome and end-stage renal disease. The pathogenesis is still unknown, although the body of evidence suggests that focal and segmental glomerular sclerosis is caused by a not clearly identified circulating factor that alters the permselectivity of the glomerular barrier. Proteinuria is followed by podocyte injury. Glucocorticoids, calcineurin inhibitors, cytotoxic agents and mycophenolate mofetil, either given alone or in combination, may obtain complete or partial remission of proteinuria in 50-60% of patients and protect them from end-stage renal disease, but the remaining patients are resistant to the available drugs. A number of new drugs, including rituximab, galactose and antifibrotic agents, are under investigation.
authors: Division of Nephrology, IRCCS Humanitas Hospital, via Manzoni 56,20089 Rozzano, Milano, Italy. ponticelli.claudio@gmail.com
authors: Claudio
authors: C
authors: Ponticelli
authors: Giorgio
authors: G
authors: Graziani
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D065095:Calcineurin Inhibitors; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000473:pathology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000209:etiology / Q000473:pathology; D011507:Proteinuria / Q000150:complications / Q000473:pathology; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D065095:Calcineurin Inhibitors; D005938:Glucocorticoids; D000069283:Rituximab; D009173:Mycophenolic Acid