Absolute incidence and prevalence of focal segmental glomerulosclerosis (FSGS) are limited by global differences in the indications for, and accessibility of, kidney biopsy.[4]Rosenberg AZ, Kopp JB. Focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2017 Mar 7;12(3):502-17.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5338705
http://www.ncbi.nlm.nih.gov/pubmed/28242845?tool=bestpractice.com
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]McGrogan A, Franssen CF, de Vries CS. The incidence of primary glomerulonephritis worldwide: a systematic review of the literature. Nephrol Dial Transplant. 2011 Feb;26(2):414-30.
https://academic.oup.com/ndt/article/26/2/414/1895374
http://www.ncbi.nlm.nih.gov/pubmed/21068142?tool=bestpractice.com
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).[6]O'Shaughnessy MM, Hogan SL, Poulton CJ, et al. Temporal and demographic trends in glomerular disease epidemiology in the southeastern United States, 1986-2015. Clin J Am Soc Nephrol. 2017 Apr 3;12(4):614-23.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383393
http://www.ncbi.nlm.nih.gov/pubmed/28325866?tool=bestpractice.com
In this study, the frequency of FSGS increased in the early decades, but then plateaued and ultimately declined.[6]O'Shaughnessy MM, Hogan SL, Poulton CJ, et al. Temporal and demographic trends in glomerular disease epidemiology in the southeastern United States, 1986-2015. Clin J Am Soc Nephrol. 2017 Apr 3;12(4):614-23.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383393
http://www.ncbi.nlm.nih.gov/pubmed/28325866?tool=bestpractice.com
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.[7]Hogg R, Middleton J, Vehaskari VM. Focal segmental glomerulosclerosis: epidemiology aspects in children and adults. Pediatr Nephrol. 2007 Feb;22(2):183-6.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764601
http://www.ncbi.nlm.nih.gov/pubmed/17151873?tool=bestpractice.com
Black people have a 4- to 7-fold greater risk than white or Asian people of developing FSGS-induced end-stage renal failure.[8]Kitiyakara C, Eggers P, Kopp JB. Twenty-one-year trend in ESRD due to focal segmental glomerulosclerosis in the United States. Am J Kidney Dis. 2004 Nov;44(5):815-25.
http://www.ncbi.nlm.nih.gov/pubmed/15492947?tool=bestpractice.com
[9]Freedman BI, Hicks PJ, Bostrom MA, et al. Polymorphisms in the non-muscle myosin heavy chain 9 gene (MYH9) are strongly associated with end-stage renal disease historically attributed to hypertension in African Americans. Kidney Int. 2009 Apr;75(7):736-45.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698223
http://www.ncbi.nlm.nih.gov/pubmed/19177153?tool=bestpractice.com
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.[8]Kitiyakara C, Eggers P, Kopp JB. Twenty-one-year trend in ESRD due to focal segmental glomerulosclerosis in the United States. Am J Kidney Dis. 2004 Nov;44(5):815-25.
http://www.ncbi.nlm.nih.gov/pubmed/15492947?tool=bestpractice.com
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.[8]Kitiyakara C, Eggers P, Kopp JB. Twenty-one-year trend in ESRD due to focal segmental glomerulosclerosis in the United States. Am J Kidney Dis. 2004 Nov;44(5):815-25.
http://www.ncbi.nlm.nih.gov/pubmed/15492947?tool=bestpractice.com
[10]Haas M, Meehan SM, Karrison TG, et al. Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976-1979 and 1995-1997. Am J Kidney Dis. 1997 Nov;30(5):621-31.
http://www.ncbi.nlm.nih.gov/pubmed/9370176?tool=bestpractice.com
[11]United States Renal Data System. Annual data report 2018: epidemiology of kidney disease in the United States. 2018 [internet publication].
https://www.usrds.org/adr.aspx