Abstract

A 51 years old was diagnosis with nephrotic syndrome (NS) and treated with steroid and cyclosporine. He never achieve remission after 4 weeks of treatment. Histopathology lession shown a focal segmental glomerulosclerosis (FSGS). His kidney function was decreasing and eventually required hemodialysis. He was screened for hepatitis B, and HBsAg was reactive. We assume that the NS was secondary due to hepatitis B infection or in term hepatitis B virus associated nephropathy (HBVAN). Steroid resistance nephrotic syndrome (SRNS) mostly cause by FSGS. Focal segmental glomerulosclerosis is cause by podocytopathy. Genetic mutation cause alteration in gene coding for podocin. Treatment of SRNS include calcineurin inhibitor with or without low dose steroid. Evaluation of treatment done by 6 months to see if there is a minimum partial remission.