FN1 and Diffuse mesangial sclerosis: PDGF is the most potent stimulus of mesangial cell proliferation, and it also induces extracellular matrix produced by mesangial cells.[17,18] Transforming growth factor (TGF)-β induces mesangial sclerosis by enhancing the synthesis of collagen and fibronectin of mesangial cells,[19,20] and has pro-apoptotic podocyte effects, which may promote podocyte depletion and the focal segmental glomerular sclerosis lesions seen in most cases.[21] Growth factors produced by marginating platelets and cells of extramedullary hematopoiesis together with hyperviscosity aggravate the endothelial damage.[22]