Rituximab treatment of dysproteinemias affecting the kidney: a review of three cases

Am J Kidney Dis. 2007 Oct;50(4):641-4. doi: 10.1053/j.ajkd.2007.05.027.


The renal diseases associated with monoclonal immunoglobulin deposits constitute a diverse range of clinical and pathological entities. Renal prognosis is variable, and there currently are no standard treatment regimens. We describe the effect of rituximab treatment on 3 patients with renal insufficiency and proteinuria with monoclonal immunoglobulin deposits associated with glomerulonephritis on renal biopsy. Two patients with hypertension and chronic lymphocytic leukemia had a membranoproliferative glomerulonephritis pattern on kidney biopsy associated with monoclonal immunoglobulin G deposits. Both patients experienced partial remission of their disease and 1 patient was able to come off hemodialysis therapy after treatment with 7 and 11 biweekly doses of rituximab, 375 mg/m(2), in addition to angiotensin-converting enzyme inhibitor and angiotensin receptor blocker. Both patients subsequently experienced relapse of their hematologic and renal diseases and eventually progressed to end-stage renal disease and death. A third patient had diffuse proliferative glomerulonephritis with immunoglobulin G lambda deposits on renal biopsy. She was treated with an angiotensin receptor blocker and two 1,000-mg infusions of rituximab separated by 2 weeks, with sustained partial remission at 18 months' follow-up. Rituximab therapy, in addition to corticosteroids and angiotensin blockade, may improve the clinical course of patients with renal diseases associated with dysproteinemias, delaying the onset of end-stage renal failure or other adverse outcomes. Additional clinical studies should be planned.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Female
  • Humans
  • Kidney / drug effects*
  • Kidney / physiology
  • Kidney Diseases / chemically induced
  • Kidney Diseases / physiopathology
  • Male
  • Middle Aged
  • Proteinuria / drug therapy*
  • Proteinuria / physiopathology
  • Renal Insufficiency / drug therapy*
  • Renal Insufficiency / physiopathology
  • Rituximab


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab