Effect of calmodulin inhibitors combined with rituximab in the treatment of steroid-resistant nephrotic syndrome
AIM To investigate the clinical efficacy of calmodulin inhibitor(CNI)combined with rituximab in the treatment of steroid-resistant nephrotic syndrome,and to analyze the impact on the micro-inflammatory state of pediatric patients.METHODS 40 pediatric patients with steroid-resistant nephrotic syndrome who were treated in hospital from August 2019 to January 2022 were selected and divided into the study group treated with CNI in combination with rituximab(n=21)and the control group treated with CNI alone(n=19).The remission rate,biochemical indexes,inflammatory indexes and incidence of adverse events were compared between 2 groups at 6 months after treatment.RESULTS After 6 months of treatment,the treatment response rate in the study group was 90.48％,which was higher than 63.16％in the control group,with a statistically significant difference(P＜0.05).The serum total protein and albumin levels increased significantly in both groups,and the serum total protein and albumin levels in the study group were higher than those in the control group(P＜0.05).The levels of cholesterol,blood urea nitrogen and serum creatinine in 2 groups were lower than those before treatment,and the levels of the above indicators in the study group were lower than those in the control group after treatment(P＜0.05).Both levels of C-reactive protein(hs-CRP)and tumour-necrosis factor-α(TNF-α)in 2 groups decreased,and the levels of hs-CRP and TNF-α in the study group were lower than those in the control group(P＜0.05).There was no statistically significant difference in the total incidence of complications between 2 groups(P＞0.05).CONCLUSION In the treatment of steroid-resistant nephrotic syndrome,CNI combined with rituximab exhibis a better effect than that of CNI alone in improving hepatic and renal functions and alleviating the inflammatory state,without increasing the frequency of adverse reactions,which has shown good value in clinical promotion and application.
calmodulin inhibitorrituximabsteroid-resistant nephrotic syndromemicroinflammatory state
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