Focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) account for a majority of nephrotic syndrome diagnoses in US adults and children, respectively.1,2 Although commonly referred to as diseases, FSGS and MCD are, in fact, histologic injury patterns characterized by glomerular epithelial cell damage and filtration barrier defects. Clinically, both FSGS and MCD can manifest in nephrotic syndrome with heterogeneous glomerular pathology and variable responses to therapy.3 Owing to the high degree of variability associated with these phenotypes, our current classification systems, which rely on a handful of morphologic characteristics, do not fully account for the range of clinicopathologic presentations.