Background: Focal segmental glomerulosclerosis (FSGS) is a histopathological lesion characterized by scarring in specific sections of some glomeruli, accompanied by podocyte injury. Worldwide, the prevalence of FSGS and its temporal trends have not been sufficiently studied. However, some reports suggest an increase in the frequency of FSGS in recent decades. Understanding the epidemiology of FSGS is crucial for clinicians to improve diagnosis and treatment.

Objective: This study critically evaluates global prevalence trends of FSGS over the past 32 years (1992-2024), highlighting variations between countries through a systematic review.

Methods: A systematic search of Medline, Embase and ScienceDirect was conducted to identify relevant studies. The reliability of prevalence data was assessed by critical appraisal of selected publications.

Results: The prevalence of FSGS varies significantly between regions. East Asian countries have a relatively low prevalence, with a mean around 7%. In contrast, countries in South Asia, the Middle East and the Americas have a higher prevalence of around 18%. European countries show an intermediate prevalence of about 11%. African countries do not show a clear pattern, with high and low prevalence rates in different countries.

Conclusions: The prevalence of FSGS differs by geographic region and ethnicity. While South Asian countries have maintained a consistently low prevalence, other regions have experienced an increase in FSGS cases over time. This study improves the understanding of global patterns of FSGS, providing valuable epidemiological insights for clinicians and researchers.