Rituximab for childhood-onset nephrotic syndrome

Idiopathic nephrotic syndrome is the most common primary glomerular disease in children. About 80% of children with idiopathic nephrotic syndrome achieve remission with corticosteroids, although most have at least one relapse.1 Of children who relapse, about 50% relapse frequently or develop steroid-dependent disease.1 Some who are initially resistant to corticosteroids will achieve complete remission with calcineurin inhibitors, but about 30% of these children will develop frequently relapsing or steroid-dependent disease.2 Various immunosuppressive agents reduce the risk of relapse.3 Nevertheless, some children continue to relapse frequently despite continuing treatment with corticosteroids and immunosuppressive agents, which can also have serious adverse effects.