Rituximab in Patients With Phospholipase A2 Receptor-Associated Membranous Nephropathy and Severe CKD

KI Reports
Nicolas HansetKarine Dahan

Abstract

Patients with phospholipase A2 receptor (PLA2R)-associated membranous nephropathy and stage 4 or 5 chronic kidney disease are at high risk of end-stage kidney disease. In recent years, rituximab (RTX) emerged as a safe and efficient treatment for patients with PLA2R-associated membranous nephropathy. Whether its use is also appropriate in patients with an estimated glomerular filtration rate <30 ml/min per 1.73 m2 has not been investigated. We retrospectively reviewed characteristics and outcome of 13 patients with PLA2R-associated membranous nephropathy and stage 4 or 5 chronic kidney disease who received a total of 14 consecutive RTX treatments from January 2012 to March 2018. The treatment regimen consisted of either 2 weekly infusions of 375 mg/m2 or 2 RTX infusions of 1 g/d two weeks apart. When needed, the regimen was repeated to achieve immunological remission. The mean estimated glomerular filtration rate, serum albumin level, and urinary protein level at the first RTX infusion were 18 ± 7 ml/min per 1.73 m2, 25.2 ± 5.4 g/l, and 13.2 ± 7.5 g/d, respectively, with all patients being tested positive for serum PLA2R antibodies. Ten treatment courses led to an increase in estimated glomerular filtration rate and remission o...Continue Reading

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Citations

Feb 11, 2021·Journal of Clinical Medicine·Pierre RoncoHanna Debiec
Apr 10, 2021·Medicina clínica·Jorge Enrique Rojas-Rivera, Alberto Ortiz Arduán
Apr 30, 2021·KI Reports·Philipp GaucklerUNKNOWN RITERM study group
Oct 2, 2021·Nature Reviews. Disease Primers·Pierre RoncoJack Wetzels

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Methods Mentioned

BETA
biopsy
enzyme-linked immunosorbent assay
ELISA

Software Mentioned

GraphPad
GraphPad Prism

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