Reports on the worldwide increase in focal segmental glomerulosclerosis (FSGS) in childhood may have been hampered by referral bias. A true increase in FSGS possibly could alter the current practice of withholding renal biopsy in childhood nephrotic syndrome (NS) unless the patient fails to respond to a 28-day course of corticosteroid therapy.
Division of Pediatric Nephrology, Department of Pediatrics and Laboratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada. filler@cheo.on.ca