Focal segmental glomerulosclerosis (FSGS) is a histologic diagnosis based on kidney biopsy findings of focal and segmental scarring of the glomeruli, with minimal immune deposits. Patients with FSGS present clinically with progressive proteinuric chronic kidney disease (CKD). The International Study of Kidney Disease in Children described FSGS in 6.9% of children with nephrotic syndrome,1 but more recent estimates of the disease are higher.2,3 This group has been understudied in Africa.4 As in adults, FSGS is more common in Black and Hispanic children.