Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Jul 22;19(1):359.
doi: 10.1186/s13256-025-05408-7.

Primary focal segmental glomerulosclerosis in second trimester pregnancy presenting as rapidly progressive renal failure: diagnostic and therapeutic challenges: a case report

Adane Petros  1 , Addisu Melkie  1 , Yidnekachew Asrat  1 , Fitsum A Gemechu  2 , Yewondwossen Tadesse  1
Affiliations
Case Reports

Primary focal segmental glomerulosclerosis in second trimester pregnancy presenting as rapidly progressive renal failure: diagnostic and therapeutic challenges: a case report

Adane Petros et al. J Med Case Rep. .

Abstract

Background: Proteinuria in pregnancy is often attributed to preeclampsia, but primary glomerular diseases such as focal segmental glomerulosclerosis can also present during pregnancy, complicating diagnosis and management.

Case presentation: A 29-year-old gravida 2, para 1 African woman presented at 25 weeks of gestation with generalized edema and turbid urine. Initial investigations revealed nephrotic-range proteinuria (7.2 g/24 hours), hematuria with red blood cell casts, and deteriorating renal function, with serum creatinine rising from 1.8 to 5 mg/dL within 3 days. Due to worsening renal impairment, pregnancy termination was performed, leading to partial renal recovery, though nephrotic-range proteinuria persisted. Renal biopsy at 4 months postpartum confirmed primary focal segmental glomerulosclerosis.

Conclusions: Early recognition and prompt treatment of pregnancy-associated glomerular disease are vital for renal recovery. Differentiating focal segmental glomerulosclerosis from preeclampsia is essential, and targeted immunosuppressive therapy can achieve sustained remission, highlighting the need for a multidisciplinary approach.

Keywords: Case report; Immunosuppressive therapy; Primary focal segmental glomerulosclerosis; Renal failure; Second trimester pregnancy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors declare no conflicts of interest regarding the research, authorship, and/or publication of this article.

References

    1. Cheung KL, Lafayette RA. Renal physiology of pregnancy. Adv Chronic Kidney Dis. 2013;20(3):209–14. - PMC - PubMed
    1. Brown RA, Kemp GJ, Walkinshaw SA, Howse MLP. Pregnancies complicated by preeclampsia and non-preeclampsia-related nephritic range proteinuria. Obstet Med. 2013;6(4):159–64. - PMC - PubMed
    1. Munis MA, Chen Q, Hill TM, Zhuo M, Schachter AD, Bhandari SK, Hever A, Harrison TN, Fernandes AW, Sim JJ. Incidence and proportion of primary focal segmental glomerulosclerosis (FSGS) among a racially and ethnically diverse adult patient population between 2010 and 2021. Clin J Am Soc Nephrol. 2024;20(2):229–38. 10.2215/CJN.0000000590. (Epub ahead of print). - PMC - PubMed
    1. Rout P, Hashmi MF, Baradhi KM. Focal segmental glomerulosclerosis. In: StatPearls. Treasure Island: StatPearls Publishing; 2025. - PubMed
    1. Kopp JB, Nelson GW, Sampath K, Johnson RC, Genovese G, An P, Friedman D, Briggs W, Dart R, Korbet S, Mokrzycki MH, Kimmel PL, Limou S, Ahuja TS, Berns JS, Fryc J, Simon EE, Smith MC, Trachtman H, Michel DM, Schelling JR, Vlahov D, Pollak M, Winkler CA. APOL1 genetic variants in focal segmental glomerulosclerosis and HIV-associated nephropathy. J Am Soc Nephrol. 2011;22(11):2129–37. 10.1681/ASN.2011040388. (Epub 2011 Oct 13). - PMC - PubMed

Publication types

LinkOut - more resources