If FSGS is suspected and later confirmed with renal biopsy, which therapy is indicated as the next step?

• A. ACE inhibitors
• B. Prednisone therapy
• C. Immunoglobulin therapy
• D. Observation

Answer: (B)

The main idea is that primary focal segmental glomerulosclerosis is treated upfront with systemic glucocorticoids. When biopsy confirms FSGS, using prednisone targets the immune-mediated podocyte injury thought to drive the disease, often reducing proteinuria and preserving renal function. ACE inhibitors or ARBs are valuable adjuncts to lower proteinuria and control blood pressure, but they don’t address the disease process itself. Immunoglobulin therapy isn’t used for FSGS, and observing the condition would allow continued kidney damage. So, initiating prednisone therapy is the appropriate next step.