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D-galactose is a simple monosaccharide sugar being investigated as a potential therapeutic agent for focal segmental glomerulosclerosis (FSGS). In patients with FSGS, a circulating factor known as focal sclerosis permeability factor (FSPF) is thought to increase glomerular permeability to albumin, leading to proteinuria and progressive kidney damage. D-galactose is hypothesized to bind to and inactivate FSPF, thereby reducing its damaging effects on the kidney. Research led by the Children's National Research Institute has explored the use of oral D-galactose in pediatric populations with steroid-resistant nephrotic syndrome to lower FSPF levels and decrease proteinuria. Clinical evaluation has included the FONT (Novel Therapies for Resistant FSGS) Phase II trial, which compared galactose efficacy against standard medical therapies.
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