I have a 22 years old male who presented with heavy proteinuria of 2.8 Gms and renal failure with Creat of 133 and eGFR 62 mls/mt. Renal Biopsy showed FSGS. Right kidney is small and scarred at 8.0 cms contributing to 31% of GFR. Left kidney is 10.4 cms but also slightly scarred at the upper pole and contributes to 69% of GFR on DMSA. I am not sure if it is primary FSGS which has lead to scarring or it is secondary FSGS due to lower nephron numbers from the scarring. However there is no past history of reflux disease or recurrent UTI s during his childhood. Should I treat it with steroids/MMF later. Thank you for answering my question