ABSTRACT
The histological evolution of Focal Segmental Glomerulosclerosis (FSGS) is poorly documented due to variation in the time at which the biopsy is taken. We looked at patients presenting with steroid resistant nephrotic syndrome (SRNS) in which the first biopsy was performed within 3 months of presentation. FSGS lesion was demonstrable in 68.5% of cases in the first biopsy. Glomerular size was increased in 86% of patients indicating that is an early event in the course of the disease. The group was heterogenous with respect of mesangial cellularity, mesangial matrix, position of FSGS lesion in the glomeruli, glomerular size, lamina densa thickness and immunofluorescence findings. No association of morphological features was seen permitting subclassification of this group on morphological grounds. Thus, both the FSGS lesion and glomerular enlargement occur early in the evolution of idiopathic FSGS presenting with SRNS.