Pathology of minimal change nephropathy and segmental sclerosing glomerular disorders.

Minimal change nephropathy is relatively uncontroversial. This can be defined as the condition associated with the nephrotic syndrome in which glomeruli have no abnormality on light microscopy. Segmental sclerosing glomerular disorders are often called focal segmental glomerulosclerosis, one of the most controversial terms in kidney disease. The tubular opening is the earliest site at which segmental changes appear. These tip changes are not a disease in themselves. The glomerular tip lesion has tip changes in otherwise normal glomeruli. Tip changes in large glomeruli with mesangial increase can be called early classical segmental sclerosing disease. This can progress to give abnormalities at various sites, or late classical segmental sclerosing disease, corresponding with the classical descriptions of focal segmental glomerulosclerosis. Hilar abnormalities are a characteristic finding in reduced glomerular numbers. Focal segmental glomerulosclerosis is an ambiguous term, applied to many different types of segmental sclerosing glomerular disorders.