Focal segmental glomerulosclerosis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [3]

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.

Laboratory Findings

A comprehensive lab workup 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. Laboratory findings consistent with the diagnosis of focal segmental glomerulosclerosis include:[1][2]

  • CBC
    • Anemia
  • Lipid profile
    • Hyperlipidemia
  • Renal function test
    • Increased creatinine levels
    • Hypoalbuminemia
  • Blood urea nitrogen (BUN)
  • CD4 count and HIV test
  • 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
  • Urine analysis
    • Proteinuria
    • Microscopic hematuria
    • Dysmorphic red blood cells
    • Fatty casts
    • Microalbuminuria and urinary creatinine
    • Urine culture
    • Urinary protein electrophoresis

References

  1. Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH; et al. (2013). "KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis". Am J Kidney Dis. 62 (3): 403–41. doi:10.1053/j.ajkd.2013.06.002. PMID 23871408.
  2. Rosenberg AZ, Kopp JB (March 2017). "Focal Segmental Glomerulosclerosis". Clin J Am Soc Nephrol. 12 (3): 502–517. doi:10.2215/CJN.05960616. PMC 5338705. PMID 28242845.

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