Immunosuppressive treatment of focal segmental glomerulosclerosis: lessons from a randomized controlled trial

Patients with steroid-resistant focal segmental glomerulosclerosis (FSGS) may benefit from treatment with calcineurin inhibitors. A National Institutes of Health–funded FSGS multicenter study has suggested that a combination of mycophenolate mofetil and oral dexamethasone pulses was equivalent to cyclosporine. However, since the study was underpowered, one cannot draw firm conclusions from this study. The FSGS trial underscores that FSGS is not one disease and that better predictors of outcome and response to therapy are needed.