Kidney Disease Treatment With Rituximab

Rituximab, sold under the brand name Rituxan, is a drug originally formulated for treatment of non-Hodgkin's lymphoma. It is not actually approved for treatment of kidney disease, but some studies indicate it could be useful against this disorder. Rituximab does have some side effects, and patients should always research any drug before taking it.

Function

• Rituximab is a monoclonal antibody that was introduced in the late 1990s to treat non-Hodgkin's lymphoma. According to Nature Clinical Practice Nephrology, it works against the CD20 molecule found on pre-B and mature B cells, though not on plasma cells. Rituximab has also been found to be effective against autoimmune diseases, possibly by inhibiting activation of immune T-cells. Patients with autoimmune kidney damage may get some relief from this drug.

Benefits

• According to MedPage Today, Rituximab has been shown to reverse kidney damage from membranous nephropathy, a kidney disorder involving inflammation inside the organ. Membranous nephropathy is one of the most common kidney diseases caused by the immune system, and involves overactivity of B cells, the producers of immunoglobins or antibodies.

Expert Insight

• The American Journal of Hematology notes that Rituximab is not eliminated by hemodialysis, more commonly called simply dialysis. In a case involving a 54-year-old man with renal failure on dialysis, the levels of Rituximab in the blood increased gradually after every treatment. The resultant levels of B-cell function were eventually comparable to the levels of people who had normal kidney function.

Considerations

• Rituximab is only effective in people who have kidney disease caused by their immune systems. Kidney problems caused by other sources are unlikely to be affected by this drug. Some people get fewer benefits from Rituximab. According to Nature Clinical Practice Nephrology, B-cell depletion was less likely to occur in African-American patients.

Warning

• According to the manufacturer, Genentech, Rituximab can have some significant side effects. Serious infusion reactions may occur within 24 hours of receiving the drug. These can include hives; rashes; swelling of the lips, tongue, face or throat; and breathing problems. Some people also suffer from tumor lysis syndrome. Caused by the fast breakdown of cancer cells, it can result in renal failure and abnormal heart rhythms.