Gembillo G, Sessa C, Santoro D. Advances in the pathophysiology and treatment of focal segmental glomerulosclerosis: The importance of a timely and tailored approach. World J Nephrol 2025; 14(2): 103039 [DOI: 10.5527/wjn.v14.i2.103039]
Corresponding Author of This Article
Guido Gembillo, MD, PhD, Assistant Professor, Unit of Nephrology and Dialysis, AOU "G. Martino", University of Messina, Via Consolare Valerian 1, Messina 98125, Sicilia, Italy. ggembillo@gmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Jun 25, 2025; 14(2): 103039 Published online Jun 25, 2025. doi: 10.5527/wjn.v14.i2.103039
Advances in the pathophysiology and treatment of focal segmental glomerulosclerosis: The importance of a timely and tailored approach
Guido Gembillo, Concetto Sessa, Domenico Santoro
Guido Gembillo, Domenico Santoro, Unit of Nephrology and Dialysis, AOU "G. Martino", University of Messina, Messina 98125, Sicilia, Italy
Concetto Sessa, Unit of Nephrology and Dialysis, P.O. Maggiore "Nino Baglieri", Ragusa 97100, Sicilia, Italy
Co-corresponding authors: Guido Gembillo and Concetto Sessa.
Author contributions: Gembillo G, Sessa C, and Santoro D contributed equally to the design and implementation of the paper and to the writing of the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guido Gembillo, MD, PhD, Assistant Professor, Unit of Nephrology and Dialysis, AOU "G. Martino", University of Messina, Via Consolare Valerian 1, Messina 98125, Sicilia, Italy. ggembillo@gmail.com
Received: November 18, 2024 Revised: January 14, 2025 Accepted: January 21, 2025 Published online: June 25, 2025 Processing time: 154 Days and 16.3 Hours
Abstract
Focal segmental glomerulosclerosis (FSGS) is a histological pattern of glomerular damage that significantly contributes to chronic kidney disease and end-stage renal disease. Its incidence is rising globally, necessitating timely and personalized management strategies. This paper aims to provide an updated overview of the pathophysiology, diagnosis, and therapeutic strategies for FSGS, emphasizing the importance of early interventions and tailored treatments. This editorial synthesizes key findings from recent literature to highlight advancements in understanding and managing FSGS. Emerging evidence supports the role of targeted therapies and personalized approaches in improving outcomes for FSGS patients. Advances include novel biomarkers, genetic testing, and innovative therapeutics such as transient receptor potential ion channel blockers and antisense oligonucleotides for apolipoprotein 1-related FSGS. Effective management of FSGS requires a combination of timely diagnosis, evidence-based therapeutic strategies, and ongoing research to optimize patient outcomes and address gaps in the current understanding of the disease.
Core Tip: Focal and segmental glomerulosclerosis is currently considered a histologic pattern encompassing several clinicopathologic entities. Its incidence is increasing worldwide. The rising prevalence is likely due to improved diagnosis and recognition of the disease, combined with a better understanding of the pathophysiology of podocyte damage and the development of therapeutics targeting the mediators underlying this clinicopathologic condition.
