An exceptional story!!!

There is a young girl living who was diagnosed with FSGS at the age of 3. She was placed on the kidney waiting list for nearly 2 years. Yes, she did receive the kiney transplant, however, the disease did remained. This shows that kidney transplant doesn't cure the disease. Within 24 hrs. the disease reoccured and she had undergone dialysis.

Doctor Stuart Goldstein at Texas Children's Hospital started pheresis treatment.

Check out the article...to see what happened!!!

Texas Children's Hospital

Renal Failure...Now What???

ESRD - End Stage Renal Disease

To stay alive, a patient with ESRD must go on dialysis--hemodialysis or peritoneal dialysis--or receive a new kidney through transplantation. With the help of dialysis or transplantation, many people continue to lead full, productive lives after reaching ESRD. -- NephCure


It is important for people with FSGS know the many options that there are out there to help manage with the disease. More research needs to be made about the disease. Since there isn't an exact cause it makes it difficult to manage.

Where to get more information?

1. National Kidney and Urologic Diseases Information Clearinghouse
2. Univeristy of North Carolina Kidney Center
3. NephCure

If anyone comes across any other wonderful websites please feel free to recommend them!!!

What nurses can do?

Patient Education (very Important)
- medications
- diet
- safety
- support groups
- educational pamphlets
- provide emotional support

Medications 4-1-1

ACE inhibitors - to treat high blood pressure.

Examples of ACE inhibitors include:

Benazepril (Lotensin)
Enalapril (Vasotec)
Lisinopril (Prinivil, Zestril)

Side effects include dry cough, increased blood-potassium level, rash. ACE
inhibitors can cause localized areas of your tissues to swell up. If it occurs in the throat, that swelling can be life-threatening (BREATHING COMPROMISED)!!!

My patient experienced these symptoms, dry cough, rash, and couldn't tolerate the Enalapril.


ARBs - Angiotensin II Receptor Blockers (ARBs)to treat high blood pressure

Side effects include chest pain, unrelenting headache, swelling of extremities, face, or tongue,muscle weakness or pain, or diffulty breathing or an unusual cough.

Cozaar (Losartan)
Diovan (Valsartan)
Avapro (Irbesartan)
Benicar (Olmesartan

A little note, my patient is allergic to both Diovan, and Enalapril. Imagine the blood pressure sky high!!!


Corticosteroids - reduce swelling and decreases the body's ability to fight infections.

Prednisone

Side effects include weight gain,muscle weakness or joint pain, changes in behavior, slow healing, extreme fatigue, vision problems, rash, and itching among others.

How is FSGS is managed?

Doctors usually high doses of steroids to help people with this disease. Treatments include steroids and immunosuppressive drugs to help some people by decreasing proteinuria and improving kidney function. Unfortunately, there are bad side effects that accompany through the use of steroids. However, they help manage the disease. As they day the benefits outweigh the risks. Also, we must remember medications to help control the blood pressure, which can be significantly high.

Some people's body respond to the steroids. Others, the disease may advance to kidney failure within years. The progression to renal failure is based on the severity of the disease, which varies in different people. According to the, National Kidney and Urologic Diseases Information Clearinghouse, it is believed that
1. No universal remedy has been found, and most patients with FSGS progress to total kidney failure over 5 to 20 years.
2. Some patients with an aggressive form of FSGS reach total kidney failure in 2 to 3 years.

What's going on in the body?

FSGS is diagnosed after scars have been seen on a kidney biopsy. Another kidney disase that may develop is nephrotic syndrome.

According to NephCure.org, these of the signs and symptoms people with FSGS may experience.

1. Proteinuria - which is large amounts of protein in the urine (foamy urine)
2. Hyproteinemia - low blood protein levels
3. Hematuria - blood in the urine (loss of Red Blood Cells)
4. Reduced glomerular filtration rate - lack of filtering of wastes from the blood
5. Swelling in body (hands and ankles - usually at the end of the day)
(eyes - when waking up in the morning)