Efficacy of extremely low-dose rituximab for primary refractory nephrotic syndrome and its influence on renal function， immunoglobulin and Toll-like receptors
ObjectiveTo explore the efficacy of extremely low-dose rituximab for primary refractory nephrotic syndrome and examine its influence on renal function， immunoglobulins and Toll-like receptors （TLRs）.MethodsFrom March 2017 to February 2020， 72 patients with primary refractory nephrotic syndrome were...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Department of Journal of Clinical Nephrology
2022-10-01
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| Series: | Linchuang shenzangbing zazhi |
| Subjects: | |
| Online Access: | http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2022.10.006 |
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| Summary: | ObjectiveTo explore the efficacy of extremely low-dose rituximab for primary refractory nephrotic syndrome and examine its influence on renal function， immunoglobulins and Toll-like receptors （TLRs）.MethodsFrom March 2017 to February 2020， 72 patients with primary refractory nephrotic syndrome were selected as research subjects and randomized into 3 groups （<italic>n</italic>=24 each）. Group A received extremely low-dose rituximab （100 mg）， group B standard dose rituximab （375 mg/m<sup>2</sup>） and group C hormone therapy. Clinical efficacy， incidence of adverse reactions and renal function parameters ［serum creatinine （Scr）， blood urea nitrogen （BUN）， 24-hour urine protein quantitative］， immunoglobulins ［immunoglobulin （Ig） A， IgG， IgM］， serum inflammatory factors ［tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）］ and TLRs （TLR4， TLR7） levels were statistically compared among three groups. Treatment expenses of rituximab were compared between groups A and B.ResultsThe clinical remission rate of group A/B was higher than that of group C （<italic>P</italic><0.05）. After 2/4-week treatment， the quantitative levels of Scr， BUN and 24 h-urinary protein were lower in group A/B than those in group C. And IgA， IgG and IgM were higher than those in group C （<italic>P</italic><0.05）. After 2/4-week treatment， serum levels of TNF-α， IL-6， TLR4 and TLR7 were lower in group A/B than those in group C （<italic>P</italic><0.05）. No significant difference existed in serum levels of TNF-α， IL-6， TLR4 and TLR7 between groups A and B （<italic>P</italic>>0.05）. The incidence of adverse reactions was lower in group A than that in group B/C （<italic>P</italic><0.05） and no significant difference existed in the incidence of adverse reactions between groups B and C （<italic>P</italic>>0.05）. Treatment expense of rituximab was lower in group A than that in group B （<italic>P</italic><0.05）.ConclusionFor primary refractory nephrotic syndrome， extremely low-dose rituximab can significantly improve renal and immune functions， lower the level of Toll-like receptors， reduce the incidence of adverse reactions and curtail treatment expenses. It is worthy of wider clinical applications. |
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| ISSN: | 1671-2390 |