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Rituximab in idiopathic nephrotic syndrome: does it make sense?

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Abstract

Idiopathic nephrotic syndrome (INS) includes three different entities: minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and mesangial proliferative glomerulonephritis. Historically, this condition has been attributed to a T-cell disorder resulting in the secretion of a circulating factor that increases glomerular permeability to plasma proteins. The therapeutic approach to control the proteinuria of INS remains the use of drugs that have been considered to suppress the production of the “circulating factor” secreted by T cells. Recently, rituximab (RTX), a chimeric monoclonal antibody directed against the CD20 cell surface receptor expressed on B cells, has emerged as potential therapeutic agent. The number of publications reporting clinical experience with RTX in the treatment of nephrotic syndrome has greatly increased in the last few years. However, there is currently no good evidence from clinical or experimental studies that support a role of RTX in the treatment of MCD and FSGS proteinuria. In summary, there is the need for a better understanding of the pathogenesis of the proteinuria in INS and the potential role of RTX in this condition.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, University of Florida, 1600 SW Archer Rd. HD214, Gainesville, FL, 32610, USA

    Gabriel Cara-Fuentes & Eduardo H. Garin

  2. Department of Biostatistics, University of Florida, Gainesville, FL, 32610, USA

    John A. Kairalla

  3. Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado, Denver, Colorado, USA

    Takuji Ishimoto, Christopher Rivard & Richard J. Johnson

Authors
  1. Gabriel Cara-Fuentes
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  2. John A. Kairalla
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  3. Takuji Ishimoto
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  4. Christopher Rivard
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  5. Richard J. Johnson
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  6. Eduardo H. Garin
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Correspondence to Eduardo H. Garin.

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Cara-Fuentes, G., Kairalla, J.A., Ishimoto, T. et al. Rituximab in idiopathic nephrotic syndrome: does it make sense?. Pediatr Nephrol 29, 1313–1319 (2014). https://doi.org/10.1007/s00467-013-2534-4

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  • DOI: https://doi.org/10.1007/s00467-013-2534-4

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