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Focal segmental glomerulosclerosis (FSGS) is a common progressive chronic renal disease. Podocyte injury and loss are the postulated pivotal events that trigger FSGS. In this study, the authors aim to examine the evolution of FSGS in murine models histologically, ultrastructurally and immunohistochemically with special emphasis on podocytes and parietal epithelial cells (PECs).FSGS resembling primary FSGS in humans was initiated in Wistar rats using intravenous Adriamycin injections. Blood and urine analysis were performed at 0, 8, and 12 weeks. Both the control kidneys and the test kidneys were harvested at 8 and 12 weeks, examined histologically and ultrastructurally and the findings correlated with the glomerular expression of immunostains specific for podocytes (WT-1) and for activated PECs (CD44).FSGS developed in both 8 and 12 weeks test groups showing progressive proteinuria, podocytopathy and segmental glomerular scarring. There was a decrease in the glomerular expression of WT-1 with a concurrent increase in the glomerular expression of CD44, indicating podocyte loss with synchronous increase in activated PECs. The evolving FSGS correlated negatively with podocytes and positively with activated PECs.Our study shows that with podocyte injury there is podocyte effacement and loss, proteinuria, glomerular segmental adhesion and scarring, all culminating in FSGS. In addition, there is activation, hyperplasia and hypertrophy of PECs. This demonstrates that both podocyte loss and PEC activation promote FSGS. Our findings are consistent with recent investigations. More studies are required to further understand the role of these cells in the evolution of FSGS and subsequently introduce new targeted treatment modalities.

Hypertension is an important risk factor for the commonest cause of death among men, namely, cardiovascular diseases. The purpose of this study was to provide data concerning gender difference in the awareness, treatment, and control of hypertension in adults. We conducted a cross-sectional study in Riyadh, the capital city of Saudi Arabia. Subjects were asked if they had been told by a physician that they had hypertension or were on blood pressure (BP) medication. Blood pressure was measured using standardized Joint National Committee (JNC) protocol. The study sample consisted of 814 adults who were at least 18 years old. Of the estimated 27.6% people with hypertension, 38.6% were unaware of their hypertension, 29.8% were aware of their condition but were not being treated, and among those who had been treated 40.8% remained uncontrolled. Independent predictors of a lack of awareness of hypertension were an age of at least 45 years, male gender, and BMI greater than 30. The extent of awareness and control of hypertension did not differ significantly by monthly income, educational level, physical activities, or smoking status. Awareness and control of hypertension is low in men, making them public health priorities. Achieving more stringent BP control will require increased attention by physicians and public education to improve the awareness and control of hypertension.