A 73-year-old woman presented to a local medical facility with the initial symptoms of lower-limb edema, puffy eyes, urinary frequency, and dyspnea on exertion. Laboratory examinations: Deteriorated renal function with elevated blood urea nitrogen (45.4 mg/dL) and creatinine (4.79 mg/dL) levels. Urinalysis: Proteinuria score of 3+, RBCs: 4 per high-power field, WBCs: 4.4 per high-power field, and a spot urine creatinine ratio of 7.5 g/day.
Glomerular filtration rate (GFR) of 10 mL/min/ 1.73 m2 Spot urine protein-to-creatinine ratio in the range of 27.38 g/day, indicating proteinuria. Renal biopsy revealed focal segmental glomerulosclerosis (FSGS) Management: The patient was on course with pulse therapy with methylprednisolone (500 mg daily for 3 days). A diuretic (furosemide) with simultaneous albumin infusion was administered, but patient responded poorly with progressive increase in…
