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Focal segmental glomerulosclerosis (FSGS) is the leading glomerular cause of  nephrotic syndrome among African Americans and is typically associated with edema, proteinuria, hypertension, microscopic hematuria, and renal insufficiency. MD Newsline recently interviewed nephrologist Dr. Frita Mcrae about FSGS and kidney disease in Black patient populations.

MD Newsline: Dr. Frita, in regard to FSGS why is this rare kidney disease more prevalent in patients of color, especially African Americans?

Dr. Frita: While we don’t know exactly why it is more prevalent, we believe that it has a lot to do with genetic makeup. It may also have to do with certain environmental issues as well as diet and high salt intake. Primarily though, we believe that it is mostly genetic. What we refer to as Idiopathic FSGS, is inherited by no fault or lifestyle issue of one’s own. There’s also another form of FSGS that is directly associated with HIV, which we know disproportionately affects African Americans.  So, once again, there is no definite reason but the widely accepted belief is that it is mainly caused by genetics or environmental issues.

MD Newsline: What treatment options do you recommend for FSGS today?

Dr. Frita: There are different forms of chemotherapy and immunodepressants that are recommended. Ultimately, if we are unable to treat FSGS successfully, then patients will likely need to receive kidney transplants.

MD Newsline: Research shows that 35% of patients in the US that are on dialysis are African American. Can you speak to why we see this is?

Dr. Frita: Diabetes is the number one cause of kidney failure in this country, and African Americans are by far disproportionately affected by diabetes. As we know, diabetes can be silent, and patients can be asymptomatic for years. By the time many of these patients are diagnoses, they are likely already suffering from issues such as kidney failure, heart disease, or poor circulation, leading to amputations. Many high-risk patients have challenges with accessing care related to socioeconomic status. Some patients are not able to afford regular, preventive care. I’ve experienced this in my practice, where I’m telling a patient “you have diabetes AND kidney failure” all in the same day, because they’re coming to me with symptoms.

MD Newsline: What advice do you have for healthcare professionals hoping to help equip high-risk patients with the information and resources needed to improve and better manager their condition?

Dr. Frita: Education. Education. Education. Patients cannot prevent an illness if they are unaware of it. Medicine goes beyond our officers and even when I am at church or community fairs; anytime I am around at-risk populations, I speak about diabetes and high blood pressure, which are the top two causes of kidney failure. I explain to that even when patients are asymptomatic, these conditions lead to kidney failure. I also participate in free screening events that screen for diabetes, high blood pressure and kidney disease. I believe the most important thing is educating patients at large, particularly African Americans, to make them aware that these diseases are manageable and preventable, if they put their health first.

Dr. Frita is the founder and president of Midtown Atlanta Nephrology, PC. She is a vibrant, witty, and striking 6-foot-tall Atlanta physician, who is triple board certified in Nephrology, Internal Medicine, and Pediatrics

Learn more about a paid FSGS Study here