De Novo Focal Segmental Glomerulosclerosis
Anthony Chang, MD
Key Facts
Etiology/Pathogenesis
Hyperfiltration
Severe vascular disease
Drug-induced
Clinical Issues
Proteinuria, nephrotic range
Chronic allograft dysfunction
Microscopic Pathology
Focal, segmental glomerulosclerosis or collapsing glomerulopathy
Arterial or arteriolar sclerosis
Top Differential Diagnoses
Recurrent FSGS
Chronic transplant glomerulopathy
Immune complex-mediated glomerulonephritis
 Collapsing type de novo focal segmental glomerulosclerosis (FSGS) in a renal transplant patient with nephrotic-range proteinuria shows prominent adjacent visceral epithelial cells (podocytes)  . |
 Prominent podocytes  overlie a collapsed tuft in this case of de novo collapsing glomerulopathy in a transplant patient with severe proteinuria whose original disease was diabetic nephropathy. |
TERMINOLOGY
Abbreviations
Focal segmental glomerulosclerosis (FSGS)
Synonyms
Collapsing glomerulopathy (CG)
Variant of FSGS
Definitions
FSGS or its variants in kidney transplant patients with original disease not due to FSGS
ETIOLOGY/PATHOGENESIS
Hyperfiltration
Pediatric kidneys transplanted into adult recipients
Longstanding allografts with severe nephron loss
Severe Vascular Disease
De novo CG associated with deceased-donor kidneys
Zonal distribution of CG
