Primary Focal Segmental Glomerulosclerosis Presenting With Acute Kidney Injury and Nephrotic Syndrome: A Case Report With Sustained Remission

Focal segmental glomerulosclerosis (FSGS) is a common cause of nephrotic syndrome in adults, characterized by segmental scarring of the glomeruli. It can present with proteinuria, hypoalbuminemia, edema, and varying degrees of renal dysfunction. Early diagnosis and treatment are critical to prevent progression to end-stage kidney disease. We report the case of a 53-year-old female who presented with worsening generalized edema, abdominal distension, and significant weight gain. Laboratory workup revealed significant proteinuria, hypoalbuminemia, and acute kidney injury, and kidney biopsy confirmed the diagnosis of FSGS. She was treated with high-dose corticosteroids, followed by initiation of losartan, and over a two-year follow-up period, she achieved and maintained complete remission with stable renal function and no recurrence of proteinuria. This case highlights the importance of prompt diagnosis and early intervention in FSGS. High-dose corticosteroids remain the cornerstone of treatment for primary FSGS, with adjunctive renin-angiotensin system blockade playing a key supportive role. Long-term follow-up is essential to monitor treatment response and maintain remission.