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Frontiers in Medical Science Research, 2023, 5(5); doi: 10.25236/FMSR.2023.050516.

Advances in the treatment of refractory nephrotic syndrome in children

Author(s)

Jiaying Ma1, Chunying Liu2

Corresponding Author:
Chunying Liu
Affiliation(s)

1Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China

2Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712000, China

Abstract

Nephrotic syndrome is the most common glomerular disease in children, mostly seen in children aged 3-5 years, and is often treated clinically with hormone therapy, but some children with hormone therapy have poor results, manifesting as frequent relapses, hormone dependence or hormone-resistant refractory nephrotic syndrome, and children with long-term hormone use show adverse effects such as growth inhibition, fat metabolism disorders, and infections, which seriously affect the quality of survival. In recent years, various types of immunosuppressants have been used in children with refractory nephrotic syndrome to maintain disease remission, reduce relapses, and reduce the adverse effects of hormones, providing more therapeutic options for treatment.

Keywords

refractory nephrotic syndrome in children; rituximab; pharmacotherapy

Cite This Paper

Jiaying Ma, Chunying Liu. Advances in the treatment of refractory nephrotic syndrome in children. Frontiers in Medical Science Research (2023) Vol. 5, Issue 5: 105-113. https://doi.org/10.25236/FMSR.2023.050516.

References

[1] Downie ML, Gallibois C, Parekh RS, et al. Nephrotic syndrome in infants and children: pathophysiology and management [J]. Paediatr Int Child Health. 2017; 37 (4):248-258. 

[2] Lombel RM, Gipson DS, Hodson EM, et al. Treatment of steroid-sensitive nephrotic syndrome: new guidelines from KDIGO [J]. Pediatr Nephrol. 2013; 28 (3):415-26.

[3] Li L, Zhu M, Li DY, et al. Dose tailoring of tacrolimus based on a non-linear pharmacokinetic model in children with refractory nephrotic syndrome [J]. Int Immunopharmacol. 2021; 98: 107827. 

[4] Chen S P, Li G S. Genetic background testing for refractory nephrotic syndrome and clinical applications [J]. Journal of Practical Hospital Clinics. 2020, 17(03): 256-259.

[5] Dai L, Zhang YJ, et al. Progress of hormone-resistant nephrotic syndrome gene research status agent [J]. Journal of Clinical Internal Medicine, 2021, 38(10):716-718.

[6] Qin M, Wang Mo. Pharmacogenomics-based therapeutic strategies for refractory nephrotic syndrome_ Qin M [J]. Journal of Pediatric Pharmacology, 2022, 28(6): 58-62.

[7] Sun N, Chang WX. Research progress of rituximab for refractory nephrotic syndrome_Sun Na [J]. Chinese Prescription Drugs, 2022, 20(5): 154-156.

[8] Lin J, Sun J. Rituximab May Have Positive Effect on Refractory Nephrotic Syndrome: A Meta-Analysis of Randomized Trials [J]. Comput Math Methods Med. 2022; 2022: 3008597. 

[9] Al-Zoobi L, Salti S, Colavecchio A, et al. Enhancement of Rituximab-induced cell death by the physical association of CD20 with CD40 molecules on the cell surface[J]. Int Immunol. 2014; 26 (8):451-65. 

[10] Weiner GJ. Rituximab: mechanism of action. Semin Hematol [J]. 2010 Apr; 47(2):115-23.

[11] Del Vecchio L, Allinovi M, Rocco P, et al. Rituximab Therapy for Adults with Nephrotic Syndromes: Standard Schedules or B Cell-Targeted Therapy? [J]. J Clin Med. 2021; 10 (24). 

[12] Mathew G, Sinha A, Ahmed A, et al. Efficacy of rituximab versus tacrolimus in difficult-to-treat steroid-sensitive nephrotic syndrome: an open-label pilot randomized controlled trial[J]. Pediatr Nephrol. 2022 Mar; 1-10.

[13] Meeuwisse C, Morgan CJ, Samuel S, et al. Rituximab Use for the Treatment of Childhood Nephrotic Syndrome by Canadian Pediatric Nephrologists: A National Survey[J]. Can J Kidney Health Dis. 2022; 9: 20543581221079959. 

[14] Takahashi T, Okamoto T, Yokota I, et al. The effect of rituximab on the quality of life of children with refractory nephrotic syndrome [J]. Pediatr Int. 2022; 64 (1):e14725. 

[15] Xu J, Ding Y, Wan L, et al. A prospective cohort study of rituximab in the treatment of refractory nephrotic syndrome. Int Urol Nephrol [J]. 2022; 54 (1):121-130.

[16] Topaloğlu R, Gülhan B, Çelegen K, et al. Rituximab for Children With Difficult-to-Treat Nephrotic Syndrome: Its Effects on Disease Progression and Growth. Front Pediatr[J]. 2019; 7: 313.

[17] Chan EY, Webb H, Yu E, et al. Both the rituximab dose and maintenance immunosuppression in steroid-dependent/frequently-relapsing nephrotic syndrome have important effects on outcomes [J]. Kidney Int. 2020; 97 (2):393-401. 

[18] Maxted AP, Dalrymple RA, Chisholm D, et al. Low-dose rituximab is no less effective for nephrotic syndrome measured by 12-month outcome[J]. Pediatr Nephrol. 2019; 34 (5):855-863.

[19] Gao X, Wang Y, Xu Z, et al. Systematic Review and Meta-Analysis of Rituximab for Steroid-Dependent or Frequently Relapsing Nephrotic Syndrome in Children. Front Pediatr[J]. 2021;9: 626323. 

[20] Taşdemir M, Canpolat N, Yıldız N, et al. Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study [J]. Turk J Med Sci. 2021; 51 (4):1781-1790. 

[21] Guzmán Morais B, Ordóñez Álvarez FÁ, Santos Rodríguez F, et al. Rituximab treatment in pediatric patients with steroid-dependent nephrotic syndrome: A tertiary hospital. An Pediatr (Engl Ed) [J]. 2022; 96 (2):83-90.

[22] Bertrand Q, Mignot S, Kwon T, et al. Anti-rituximab antibodies in pediatric steroid-dependent nephrotic syndrome [J]. Pediatr Nephrol. 2022; 37 (2):357-365.

[23] Hogan J, Deschenes G. How to improve response to rituximab treatment in children with steroid-dependent nephrotic syndrome: answer to Drs. Fujinaga and Nishino [J]. Pediatr Nephrol. 2019; 34 (2):361-362.

[24] Delbet JD, Leclerc G, Ulinski T. Idiopathic nephrotic syndrome and rituximab: may we predict circulating B lymphocytes recovery? [J]. Pediatr Nephrol. 2019; 34 (3):529-532. 

[25] Fujinaga S, Nishino T. Risk factors for early B cell recovery following single-dose rituximab therapy in Japanese children with steroid-dependent nephrotic syndrome[J]. Pediatr Nephrol. 2019; 34 (2):359-360.

[26] Bhatia D, Sinha A, Hari P, et al. Rituximab modulates T- and B-lymphocyte subsets and urinary CD80 excretion in patients with steroid-dependent nephrotic syndrome[J]. Pediatr Res. 2018;84 (4):520-526.

[27] Fujinaga S, Nishino T, Endo S, et al. Unfavorable impact of anti-rituximab antibodies on clinical outcomes in children with complicated steroid-dependent nephrotic syndrome[J]. Pediatr Nephrol. 2020; 35(10):2003-2008.

[28] Kamei K, Ogura M, Sato M, et al. Infusion reactions associated with rituximab treatment for childhood-onset complicated nephrotic syndrome [J]. Pediatr Nephrol. 2018; 33 (6):1013-1018.

[29] Subun C, Suwannahitatorn P, Webb H, et al. Rituximab in childhood steroid-sensitive nephrotic syndrome: are multiple subsequent courses safe and effective? [J]. Arch Dis Child. 2020; null. 

[30] Iijima K, Sako M, Kamei K, et al. Rituximab in steroid-sensitive nephrotic syndrome: lessons from clinical trials [J]. Pediatr Nephrol. 2018; 33 (9):1449-1455.

[31] Inoki Y, Kamei K, Nishi K, et al. Incidence and risk factors of rituximab-associated hypogammaglobulinemia in patients with complicated nephrotic syndrome [J]. Pediatr Nephrol. 2022; 37 (5):1057-1066. 

[32] Parmentier C, Delbet JD, Decramer S, et al. Immunoglobulin serum levels in rituximab-treated patients with steroid-dependent nephrotic syndrome[J]. Pediatr Nephrol. 2020; 35 (3):455-462.

[33] Chan EY, Ma AL, Tullus K. Hypogammaglobulinaemia following rituximab therapy in childhood nephrotic syndrome [J]. Pediatr Nephrol. 2022; 37 (5):927-931.

[34] Kimura Y, Kiyota K, Ikeuchi M, et al. Rituximab-induced serum sickness in a girl with nephrotic syndrome [J]. CEN Case Rep. 2022; doi:10.1007/s13730-022-00709-y

[35] Guzzi F, Giovannini M, Errichiello C, et al. Hypokalemia After Rituximab Administration in Steroid-Dependent Nephrotic Syndrome: A Case Report [J]. Front Pharmacol. 2020; 11: 915.

[36] Kakleas K, Kirk K, Harris D, et al. Successful desensitization to high dose rituximab for a child with nephrotic syndrome - The first report in the literature [J]. Asia Pac Allergy. 2021; 11 (4):e37.

[37] Nishiwaki H, Oikawa M, Kajitani H, et al. Disseminated Intravascular Coagulation-like Reaction after Rituximab Infusion in a Patient with Nephrotic Syndrome[J]. Intern Med. 2019; 58 (14): 2057-2061.

[38] Morita K, Shibano T, Maekawa K, et al. Crohn's disease following rituximab treatment in a patient with refractory nephrotic syndrome [J]. CEN Case Rep. 2019; 8 (1):55-60. doi:10.1007/s 13730-018-0364-8

[39] Kobayashi M, Kageyama Y, Ando T, et al. All-case Japanese post-marketing surveillance of the real-world safety and efficacy of rituximab treatment in patients with refractory nephrotic syndrome[J]. Clin Exp Nephrol. 2021; 25 (8):854-864. 

[40] Sinha R, Marlais M, Sarkar S, et al. Impact of COVID-19 pandemic on use of rituximab among children with difficult nephrotic syndrome[J]. Pediatr Res. 2021; null. 

[41] Guo HL, Xu J, Sun JY, et al. Tacrolimus treatment in childhood refractory nephrotic syndrome: A retrospective study on efficacy, therapeutic drug monitoring, and contributing factors to variable blood tacrolimus levels [J]. Int Immunopharmacol. 2020; 81: 106290. 

[42] Chen HX, Cheng Q, Li F, et al. Efficacy and safety of tacrolimus and low-dose prednisone in Chinese children with steroid-resistant nephrotic syndrome[J]. World J Pediatr. 2020; 16 (2):159-167. 

[43] Li L, Guo H-L et al. Therapeutic drug monitoring of tacrolimus in a pediatric nephrotic syndrome population[J]. Chinese Journal of Pharmacy,2021,56(23):1880-1886.

[44] Liu Fuxing, Zheng Qingfeng, Cai Liping. Analysis of the effects of cyclophosphamide therapy on laboratory-related indicators in hormone-resistant pediatric nephrotic syndrome[J]. Medical Theory and Practice, 2021, 34(22):3963-3965.

[45] Sandhu J, Bhat D, Dhooria GS, et al. Oral cyclophosphamide therapy in 100 children with steroid-sensitive nephrotic syndrome: experience from a developing country[J]. Pediatr Nephrol. 2021;36 (9):2759-2767. 

[46] Haddad M, Kale A, Butani L. Intravenous cyclophosphamide induces remission in children with difficult to treat steroid resistant nephrotic syndrome from minimal change disease[J]. BMC Nephrol. 2021;22 (1):395. 

[47] Widiasta A, Wahyudi K, Sribudiani Y, et al. The level of transforming growth factor-β as a possible predictor of cyclophosphamide response in children with steroid-resistant nephrotic syndrome [J]. Biomedicine (Taipei). 2021;11 (3):68-75. 

[48] Querfeld U, Weber LT. Mycophenolate mofetil for sustained remission in nephrotic syndrome[J]. Pediatr Nephrol. 2018; 33 (12):2253-2265. 

[49] Karunamoorthy S, Thanigachalam D, Jeyachandran D, et al. The safety and efficacy of mycophenolate mofetil in children and adolescents with steroid-dependent nephrotic syndrome: a single-centre study [J]. Clin Kidney J. 2020; 13 (2):179-183. 

[50] Xiang X, Qiu SY, Wang M. Mycophenolate Mofetil in the Treatment of Steroid-Dependent or Frequently Relapsing Nephrotic Syndrome in Children: A Meta-Analysis[J]. Front Pediatr. 2021; 9: 671434.

[51] Wei S. L. Clinical effect study of cyclosporine A in the treatment of pediatric refractory nephrotic syndrome [J]. Chinese Prescription Drugs, 2020, 18(02):94-95.

[52] Li HY, Zhang X, Zhou T, et al. Efficacy and safety of cyclosporine a for patients with steroid-resistant nephrotic syndrome: a meta-analysis[J]. BMC Nephrol. 2019; 20 (1):384. 

[53] Abedini A. Is medium dose of cyclosporine A effective in treatment of children with steroid-dependent nephrotic syndrome with reduction in corticosteroids dose consumption? [J]. Clin Exp Nephrol. 2019; 23 (2):287-288. 

[54] Liu X, Li G, Liu X, et al. Clinical nephrotoxicity induced by cyclosporin A combined with hormone therapy for nephrotic syndrome[J]. Pak J Pharm Sci. 2021; 34 (6(Special)):2441-2445. 

[55] Shen LH, Yu HT. Correlation analysis of cyclosporine trough concentration/dose ratio and hematological indices in patients with refractory nephrotic syndrome [J]. Chinese Journal of Health Examination, 2021, 31(18):2229-2233.