## 4 Research and Project Aimed at Developing Modules of a Classification and Expert System
### Management and Treatment Module  
The management and treatment module of the expert system provides clinicians with structured, evidence-based guidance for treating FSGS [66]. This module is divided into two main sub-modules: **basic management and treatment** and **induction therapy with periodic evaluation**, each offering specific recommendations tailored to the patient's clinical needs. An overview of the module's operating principles is presented in Figure 4, while detailed recommendations are described later in this section. Figure 3: Example of FSGS diagnostic module screen (first module from Figure 1). The **basic management and treatment** sub-module (see Figure 5) emphasizes nephprotective strategies, targeting both the underlying pathophysiology of FSGS and associated comorbidities. The system recommends a combination of non-pharmacological and pharmacological interventions, detailed in Table 3. \begin{table}
\begin{tabular}{l l} \hline \hline
**Category** & **Recommendations** \\ \hline \multirow{6}{*}{Non-specific measures} & * Dietary salt restriction \\  & * Caloric and fat intake reduction \\  & * Regular, individually tailored physical activity \\  & * Smoking cessation \\  & * Alcohol consumption reduction \\  & * Treatment of localized inflammatory foci (e.g., dental, ENT, gynecological) \\ \hline \multirow{2}{*}{Management of nephrotic syndrome} & * Dietary salt and fluid restriction \\  & * Use of diuretics in cases of edema \\ \hline \multirow{6}{*}{Hypertension management} & * Cardiovascular risk assessment \\  & * Lifestyle modifications: diet, exercise, weight loss, smoking cessation \\  & * Pharmacological options: ACE inhibitors, ARBs, calcium \\  & * channel blockers, beta-blockers \\ \hline \multirow{6}{*}{Hyperlipidemia management} & * Cardiovascular risk assessment \\  & * Non-pharmacological measures: diet, exercise, weight reduction \\  & * Pharmacological options: statins, fibrates, PCSK9 inhibitors \\ \hline \multirow{2}{*}{Thrombotic risk management} & * Assessment of thromboembolic and hemorrhagic risks \\  & * Use of anticoagulants: heparin, DOACs, or others \\ \hline \multirow{2}{*}{Infection risk reduction} & * Identification of contributing factors \\  & * Prophylactic measures: targeted antibiotics and vaccinations (e.g., influenza, SARS-CoV-2, pneumococcal) \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Basic management and treatment recommendations. Figure 4: Overview of the module’s operating principles. For patients requiring immunosuppressive therapy, the **induction therapy with periodic evaluation** sub-module outlines strategies for induction therapy, along with protocols for regular evaluation. This includes:  
* Glucocorticoids: recommendations for high-dose glucocorticoid therapy, including dosing schedules, treatment duration, and tapering strategies, are based on clinical response and tolerance. * Calcineurin inhibitors (CNIs): guidance on the use of cyclosporine or tacrolimus, including dose adjustments based on therapeutic drug monitoring (TDM) to minimize nephrotoxicity and optimize efficacy. * Symptomatic treatment: use of diuretics for edema and antihypertensive to manage blood pressure. * Periodic evaluation: monthly monitoring of clinical and laboratory markers, such as proteinuria, renal function, and blood counts, to assess therapeutic response and detect adverse effects. Table 4 summarizes the key elements of induction therapy.