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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/05/01 22:29:25」(JST)

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Glomerulosclerosis refers to a hardening of the glomerulus in the kidney. It is a general term to describe scarring of the kidneys' tiny blood vessels, the glomeruli, the functional units in the kidney that filter urine from the blood.

Proteinuria (large amounts of protein in urine) is one of the signs of glomerulosclerosis. Scarring disturbs the filtering process of the kidneys and allows protein to leak from the blood into urine. However, glomerulosclerosis is one of many causes of proteinuria. A kidney biopsy (removal of tiny part of kidney with a needle) may be necessary to determine whether a patient has glomerulosclerosis or another kidney problem. About 15 percent of people with proteinuria turn out to have glomerulosclerosis.

Both children and adults can develop glomerulosclerosis and it can result from different types of kidney conditions. One frequently encountered type of glomerulosclerosis is caused by diabetes. Drug use or infections may cause focal segmental glomerulosclerosis (FSGS), a very chronic kidney condition. FSGS may also occur in patients with AIDS but most are of unknown cause.

Early stages of glomerulosclerosis may not produce any symptoms but the most important warning sign is proteinuria, usually discovered in routine medical exams. Losing large amounts of protein may cause swelling in the ankles and accumulation of fluid in the abdomen.

Scarred glomeruli cannot be repaired and many patients with glomerulosclerosis get worse over time until their kidneys fail. This condition is called end-stage renal disease (ESRD) and the patients must begin dialysis treatment or receive a kidney transplant. ESRD may be reached within a year or up to ten or more of diagnosis of glomerulosclerosis but time will vary.

Treatments for glomerulosclerosis depend on what caused the scarring of the glomeruli. This is determined by renal biopsy. Immunosuppressive drugs stop proteinuria in some patients, but once the treatments have ended proteinuria will continue. The drugs may sometimes damage the patient’s kidneys even more.

Controlling the patient’s blood pressure may control the progression of kidney failure. ACE inhibitors, a type of blood pressure medicine, preserve kidney function in patients with diabetes. ACE inhibitors may also slow down kidney failure for patients without diabetes. Low protein diets may also lighten the work done by kidneys to process waste. Some patients will need to control their cholesterol through diet or both diet and medicine.

Related diseases

More specifically, glomerulosclerosis can refer to:

Focal segmental glomerulosclerosis
Nodular glomerulosclerosis (diabetic)

References

Glomerulosclerosis--WebMD

UpToDate Contents

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1. 巣状分節性糸球体硬化症の疫学、分類、および病因 epidemiology classification and pathogenesis of focal segmental glomerulosclerosis
2. 原発性巣状分節性糸球体硬化症の治療 treatment of primary focal segmental glomerulosclerosis
3. 糸球体疾患の鑑別診断および評価 differential diagnosis and evaluation of glomerular disease
4. 高血圧性腎硬化症の臨床的特徴、診断および治療 clinical features diagnosis and treatment of hypertensive nephrosclerosis
5. 移植腎における巣状分節性糸球体硬化症 focal segmental glomerulosclerosis in the transplanted kidney

English Journal

Contribution of Auger/conversion electrons to renal side effects after radionuclide therapy: preclinical comparison of (161)Tb-folate and (177)Lu-folate.

Haller S1, Pellegrini G2, Vermeulen C3, van der Meulen NP4,5, Köster U6, Bernhardt P7, Schibli R8,9, Müller C10.
EJNMMI research.EJNMMI Res.2016 Dec;6(1):13. doi: 10.1186/s13550-016-0171-1. Epub 2016 Feb 9.
BACKGROUND: The radiolanthanide (161)Tb has, in recent years, attracted increasing interest due to its favorable characteristics for medical application. (161)Tb exhibits similar properties to the widely-used therapeutic radionuclide (177)Lu. In contrast to (177)Lu, (161)Tb yields a significant numb
PMID 26860295

Recurrence of nephrotic proteinuria in children with focal segmental glomerulosclerosis: early treatment with plasmapheresis and immunoadsorption should be associated with better prognosis.

Fencl F1, Vondrák K, Rosík T, Jzieg J, Chadimová M, Háček J, Dušek J, Seeman T.
Minerva pediatrica.Minerva Pediatr.2016 Oct;68(5):348-54. Epub 2015 Jun 4.
BACKGROUND: Primary focal segmental glomerulosclerosis (FSGS) is a glomerular disease, characterized by progressive renal function deterioration, nephrotic proteinuria, and risk of chronic renal failure. We present long-term results of 5 patients with primary FSGS and recurrence of nephrotic protein
PMID 26041001

Renal parenchymal resistance in patients with biopsy proven glomerulonephritis: Correlation with histological findings.

Gigante A1, Barbano B2, Di Mario F2, Rosato E2, Simonelli M2, Rocca AR3, Conti F4, Ceccarelli F4, Giannakakis K5, Valesini G4, Cianci R2.
International journal of immunopathology and pharmacology.Int J Immunopathol Pharmacol.2016 Sep;29(3):469-74. doi: 10.1177/0394632016645590. Epub 2016 Apr 18.
Renal Doppler ultrasound is increasingly used in nephrology for the evaluation of renovascular disease, allograft dysfunction, and chronic nephropathies. We compared intrarenal hemodynamic parameters to biopsy findings of glomerular sclerosis, tubular atrophy, interstitial fibrosis, crescents, arter
PMID 27091839

Japanese Journal

Light Chain Deposition Disease Diagnosed with Laser Micro-dissection, Liquid Chromatography, and Tandem Mass Spectrometry of Nodular Glomerular Lesions

Internal Medicine 56(1), 61-66, 2017
NAID 130005239485

Age-Related Renal Microvascular Changes: Evaluation by Three-Dimensional Digital Imaging of the Human Renal Microcirculation Using Virtual Microscopy

International journal of molecular sciences 17(11), 1831, 2016-11
NAID 120005947323

症例報告妊娠蛋白尿の管理中にネフローゼ症候群を発症した巣状分節性糸球体硬化症の1例

東京産科婦人科学会会誌 65(4), 700-705, 2016-10
NAID 40020993255

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★リンクテーブル★

リンク元	「糸球体硬化症」「糸球体硬化」
拡張検索	「diabetic glomerulosclerosis」「focal segmental glomerulosclerosis」「intercapillary glomerulosclerosis」「focal glomerulosclerosis」「diffuse glomerulosclerosis」