Epidemiology

Epidemiology of focal segmental glomerulosclerosis (FSGS) varies between countries. Absolute incidence and prevalence are limited by global differences in the indications for, and accessibility of, kidney biopsy.[4] One systematic review assessing the incidence of FSGS worldwide found most annual incidence rates were between 0.2 and 1.1 per 100,000.[5]​ FSGS is believed to be the leading cause of adult nephrotic syndrome worldwide, with estimated prevalences of 20% to 30% in adults aged >15 years and 30% to 35% in adults aged >60 years.[6]

Pakistan

  • Evidence from studies of adult nephrotic patients in Pakistan suggests that FSGS is the most common cause of nephrotic syndrome.[7]

India

  • Evidence from renal biopsy results suggests that about 19% of non-neoplastic kidney disease in the Kerala region is due to FSGS.[8]

China

  • There is evidence suggesting that the majority of patients from China with obesity-related glomerulonephropathy have FSGS as well as mild obesity, visceral obesity, minor proteinuria, and preserved creatinine clearance.[9]

Kuwait

  • Evidence from biopsy results suggests that FSGS is the most common histological lesion in glomerulopathy among Kuwaiti patients, accounting for 18.0% of cases.[10]

Turkey

  • Evidence suggests that FSGS is the second most common histopathological diagnosis in Turkish children with nephrotic syndrome (membranoproliferative glomerulonephritis being the most common).[11]

Nigeria

  • Evidence from biopsy results of HIV-positive patients with proteinuria in Nigeria suggests that the majority of this patient group has the collapsing variant of FSGS, and that there is an equal male-female distribution of cases.[12]

The Netherlands

  • Evidence from biopsy results suggests that 32% of FSGS patients aged >16 years from the Nijmegen region of the Netherlands have the not otherwise specified variant of FSGS, 37% have the tip variant, 26% have the perihilar variant, and 5% have the collapsing variant; the cellular variant was not found.[13]

Brazil

  • Evidence from biopsy results suggests that FSGS is the most common primary glomerular disease (accounting for about 30% of glomerular disease cases) in the São Paulo region of Brazil.[14]

Canada

  • Evidence from Toronto General Hospital suggests that women with FSGS are on average 2 years younger at presentation than men, and have a better outcome than men.[15]

US

  • The annual incidence of FSGS in the US increased from 0.2% to 2.3% between 1980 and 2000.[16] In one temporal study of renal biopsy results showing glomerular disease in the southeastern US, FSGS was the predominant diagnosis in all eras (1986 to 2015).[17] In this study, the frequency of FSGS increased in the early decades, but then plateaued and ultimately declined.[17] In registries that record patients with end-stage renal failure, the incidence of FSGS is estimated to be 30 to 40 cases per million population for black people and 5 cases per million for white people.[18]

  • Black people have a 4- to 7-fold greater risk than white or Asian people of developing FSGS-induced end-stage renal failure.[16][19] The incidence peaks at age 40 to 49 years among black people and 70 to 79 years among white and Asian people.

  • Males have a 1.5- to 2-fold greater risk than females.[16]

  • Primary (idiopathic) FSGS is more common than secondary FSGS, and is the most common primary glomerular disease to cause end-stage renal failure in the US.[16][20][21]

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