FSGS is resistant to steroid therapy and many other immunosuppressive drugs, and is associated with poor outcome. Approximately 50% of patients with FSGS progress to ESRD within 5-10 years and in about 30% of children, FSGS can recur after transplantation.(1) Given the devastating course of this disease and the benign nature of the proposed galactose treatment, the anticipated benefits far outweigh the risks. If effective, galactose supplementation could stop the progression of FSGS, limiting glomerular damage and preventing progression of the disease to ESRD. The potential benefit of preserving kidney function and preventing the need for dialysis or transplantation is significant for both participants in this study and for other children with FSGS who may benefit from galactose therapy in the future.