Objective To explore the clinical effect of rituximab in the treatment of idiopathic membranous nephropathy in elderly patients. Methods 60 patients with idiopathic membranous nephropathy admitted to Jincheng People's Hospital from 2020-01 to 2023-12 were selected and divided into research group and control group by randomized numerical table method, with 30 cases in each group; the control group was treated with low-dose hormone combined with tacrolimus, and the research group was treated with low-dose rituximab. To observe the changes of 24 h urine protein quantification, serum albumin, blood creatinine, blood uric acid, total cholesterol, estimated glomerular filtration rate, serum antiphospholipase A2 receptor antibody titer level before treatment and at 3 and 6 months of treatment in both groups. Results Comparison of general condition and blood biochemistry before treatment in both groups showed no statistically significant difference. Two cases in the study group were withdrawn from the follow-up, and 28 cases were finally enrolled. After 3 months of treatment, urine protein quantification of the study group was 1232.0 (400.0, 3040.0) mg, with a remission rate of 53.57%, and urine protein quantification of the control group was 2204.0 (1400.0, 5725.0) mg, with a remission rate of 46.66%, and the level of early reduction of urinary protein and remission rate of the study group were better than that of the control group, with statistically significant differences (P<0.05).At 6 months of treatment, the quantitative urine protein of the study group was 2464.0 (1472.0, 3455.0) mg, with a remission rate of 71.42%, while the quantitative urine protein of the control group was 1145.0 (315.0, 3959.0) mg, with a remission rate of 66.66%, and there was a long-term and sustained remission of both the study and control groups. Conclusions Treatment of elderly idiopathic membranous nephropathy with low-dose rituximab has earlier remission rate and is safer and more efficacious when equivocal long-term remission rate is obtained.
Key words
elderly /
idiopathic membranous nephropathy /
low-dose /
rituximab /
tacrolimus
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