Histopathological Features of Primary (Idiopathic) Focal and Segmental Glomerulosclerosis (FSGS) In Renal Biopsies: A Retrospective Study about Relevance of Glomerular Findings

Daniela Cristina dos Santos Souza¹, Leticia Scaffi Oliveira¹, Diego Henrique Ferreira Mussatto¹, and Elida Paula Benquique Ojopi²*

¹Department of Pathology, São Paulo State University (Unesp), Brazil
²Clinical Hospital of Botucatu School of Medicine, Brazil

*Corresponding Author: Daniela Cristina Dos Santos Souza, Department of Pathology, São Paulo State University (Unesp), School of Medicine, Botucatu, Avenida Prof. Mário Rubens Guimarães Montenegro s/n, Botucatu-18618-687, SP, Brazil

DOI: 10.64258/3067-7130.2025.1020024

Submission Date: July 28, 2025

Published Date: August 12, 2025

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Abstract

Background: Focal and Segmental Glomerulosclerosis (FSGS) is considered one of the main causes of nephrotic syndrome and end-stage renal disease (ESRD). It is a glomerulopathy characterized by podocyte injury and proteinuria. The typical presentation shows collapse and sclerosis of a segmental pattern in the glomerulus. However, nonspecific morphological changes can be found in the glomeruli with FSGS, mainly in more recent stages. This research aims to describe all the morphological findings found in idiopathic FSGS cases and to study the statistical relevance between them and the disease. Methods: A total of 146 biopsies diagnosed with idiopathic FSGS were selected for analysis. Glomerular histological criteria were analyzed under an optic microscope including typical segmental sclerosis, global sclerosis, hyperplasia and hypertrophy of podocytes and parietal epithelial cells (PECs), presence of collapse of glomerular capillary loops, presence of adhesions, glomerular hypertrophy, among others, and were categorized as present or absent, in the biopsies studied. Results: Bivariate associations revealed that glomerular segmental sclerosis, global sclerosis, segmental endocapillar hypercellularity, glomerular increased size and number of glomeruli with increased size, podocytes with segmental hypertrophy, PECs with segmental hypertrophy and global hyperplasia showed a tendency towards statistical significance for association with idiopathic FSGS. Conclusions: We believe that the data we found can assist pathologists in their diagnostic routine, providing additional information in biopsies that do not present specific characteristics for histopathological FSGS diagnoses.

Keywords

Segmental Glomerulosclerosis; Glomerulosclerosis, Focal Segmental; Sclerosis; Podocytes, Histopathological features

Citation

Daniela CSS, Leticia SO, Diego HFM and Elida PBO (2025) Histopathological Features of Primary (Idiopathic) Focal and Segmental Glomerulosclerosis (FSGS) In Renal Biopsies: A Retrospective Study about Relevance of Glomerular Findings. On J Clin & Med Case Rep 1(5): 1-11.