Rituximab therapy for Type I membranoproliferative glomerulonephritis

Clin Nephrol. 2012 Apr;77(4):290-5. doi: 10.5414/cn107299.


Aims: Type I membranoproliferative glomerulonephritis (MPGN) is an immune-complex disease with a relatively poor prognosis. It has no established treatment in adults. Our hypothesis was that this disease would respond to B cell depletion with rituximab, an anti-CD20 monoclonal antibody.

Methods: We conducted an openlabel trial, in Canada and the United States, of rituximab in 6 adult patients with Type I MPGN (4 idiopathic, 2 with cryoglobulinemia). The rituximab dose was 1,000 mg intravenously on Day 1 and on Day 15. The patients were followed for 1 year. The primary outcome was the change in proteinuria.

Results: Peripheral blood B cells were suppressed, after rituximab, in all patients. The mean urinary protein excretion was 3.9 ± 2.0 g/d before treatment. Proteinuria fell in all patients, at all-time points, after rituximab administration. The difference was statistically significant (p < 0.05) at 6, 9 and 12 months, but not at 3 months. The minimum mean urinary protein excretion was 1.4 ± 1.4 g/d at 9 months. There were 2 complete and 3 partial remissions among the 6 patients. The creatinine clearance did not change significantly over the course of the study. There were no adverse effects.

Conclusions: Rituximab reduced proteinuria among patients with Type I MPGN. This trial suggests that B cells may play a role in this disease and that additional study of B-cell suppression is warranted.

Publication types

  • Clinical Trial, Phase II
  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Canada
  • Cryoglobulinemia / drug therapy
  • Female
  • Glomerulonephritis, Membranoproliferative / drug therapy*
  • Glomerulonephritis, Membranoproliferative / immunology
  • Humans
  • Immunologic Factors / therapeutic use*
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Prognosis
  • Proteinuria / drug therapy
  • Rituximab
  • Treatment Outcome
  • United States


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