Focal Segmental Glomerulosclerosis — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardNephrologyFocal Segmental GlomerulosclerosisRACP Paediatrics

A 10-year-old boy with steroid-resistant nephrotic syndrome has a renal biopsy showing focal segmental glomerulosclerosis (FSGS). What is the first-line treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Calcineurin inhibitor (cyclosporine or tacrolimus) plus low-dose prednisolone

KDIGO 2025 guidelines recommend calcineurin inhibitors (CNIs) such as cyclosporine or tacrolimus combined with low-dose prednisolone as first-line treatment for steroid-resistant nephrotic syndrome, including FSGS. CNIs achieve partial or complete remission in approximately 50–70% of cases. ACE inhibitors or ARBs should be added for antiproteinuric effect.

Reference: KDIGO – 2025 – Guideline for Nephrotic Syndrome in Children