KDIGO released guidelines in glomerular diseases in a Kidney International supplement this year.( image source: RFN)Topic: FSGS in Adults
1. Exclude secondary causes of FSGS , genetic testing not required routinely
2. Steroids at 1mg/kg daily as initial treatment ( 2C) if idiopathic
3. Minimum 4 week course but up to 16 weeks if not responding in 4 weeks
4. Taper over 6 months after response( Grade 2D)
5. Contraindication to steroids: use CNI( Grade 2D)
6. Relapsing FSGS should be treated just like relapsing MCD( with cyclosporine instead) for 4-6 months
7. If there is partial or complete remission, continue CNI till 12 months( 2D)
8. If cannot tolerate CNI, use combination of MMF with steroids ( 2C)
For full recommendations see: http://www.nature.com/kisup/journal/v2/n2/pdf/kisup201219a.pdf
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