Rituximab and Minimal Change Nephrotic Syndrome: a Therapeutic Option

Overview

Journal Clin Exp Nephrol

Publisher Springer

Specialty Nephrology

Date 2011 May 26

PMID 21611755

Citations 8

Authors

Takashi Takei

Kosaku Nitta

Affiliations

Soon will be listed here.

Abstract

Minimal change nephrotic syndrome (MCNS) usually responds to steroids but frequently relapses, requiring additional treatment with immunosuppressive agents. Rituximab is a chimeric murine/human monoclonal immunoglobulin G1 antibody that targets CD20, a B-cell differentiation marker. B-cell recovery begins at approximately 6 months following the completion of treatment. Rituximab has a beneficial effect, with the sustained remission or reduction of proteinuria in patients with steroid-dependent MCNS. Relapses are thought to be associated with an increase in CD19 cells. The mean serum half-life of rituximab was reported to be 10-15 days in patients with steroid-dependent nephrotic syndrome. Only infusion reactions, such as rash and chills, occurred after single-dose rituximab infusion and can be managed by pre-medication or infusion rate adjustments. Even though severe adverse effects of rituximab are not expected, physicians must be aware of potentially life-threatening adverse effects. Controlled randomized trials that include adult patients with steroid-dependent or steroid-resistant MCNS are required to prove the efficacy and safety of rituximab and to evaluate the cost-effectiveness of rituximab treatment.

Citing Articles

Steroid-resistant nephrotic syndrome as paraneoplastic syndrome of Waldenström macroglobulinemia: a case report.

Hirano K, Shirai S, Koyama T, Makinouchi R, Machida S, Matsui K CEN Case Rep. 2025; .

PMID: 39809990 DOI: 10.1007/s13730-025-00968-5.

B cell phenotype, activity, and function in idiopathic nephrotic syndrome.

Liu J, Guan F Pediatr Res. 2022; 93(7):1828-1836.

PMID: 36316536 DOI: 10.1038/s41390-022-02336-w.

Rituximab as a front-line therapy for adult-onset minimal change disease with nephrotic syndrome.

Fenoglio R, Sciascia S, Beltrame G, Mesiano P, Ferro M, Quattrocchio G Oncotarget. 2018; 9(48):28799-28804.

PMID: 29989000 PMC: 6034752. DOI: 10.18632/oncotarget.25612.

Loss of the podocyte glucocorticoid receptor exacerbates proteinuria after injury.

Zhou H, Tian X, Tufro A, Moeckel G, Ishibe S, Goodwin J Sci Rep. 2017; 7(1):9833.

PMID: 28852159 PMC: 5575043. DOI: 10.1038/s41598-017-10490-z.

A distinct lymphocyte distribution in relapse after rituximab for steroid-dependent nephrotic syndrome.

Shimizu M, Yokoyama T, Ishikawa S, Ueno K, Ohta K, Yachie A CEN Case Rep. 2017; 2(1):1-5.

PMID: 28509216 PMC: 5413719. DOI: 10.1007/s13730-012-0028-z.

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