Objective To explore the efficacy of low-dose and standard-dose Rituximab(RTX)for primary membranous nephropathy(PMN).Methods Patients with biopsy-proven PMN who received low-dose RTX and standard-dose RTX from January 2020 to June 2022 with follow-up in Peking University People's Hospital,were respectively enrolled.Clinical data and laboratory indices of these patients were collected.The patients were divided into low dose group and standard dose group according to the dosage of RTX.The differences in clinical indicators and remission rate between the two groups during baseline and follow-up were compared.The factors influencing dose selection of RTX and the risk factors of non-response to PMN treatment were discussed through multifactor analysis.Results Patients who received low dose RTX had a lower level of hemoglobin[(116.2±12.7)g/L vs.(132.6±16.2)g/L,P=0.014],and a higher level of creatinine[124.0(113.0,142.0)μmol/L vs.77.5(69.0,94.8)μmol/L,P=0.001]than patients received standard dose RTX.The overall effective rate is 67.4％,and there was no significant difference in the remission rate between the two groups(69.6％vs.65.0％,P=0.750).Multivariate logistic regression analysis showed that higher creatinine(OR 0.822,95％CI 0.684-0.987,P=0.036),lower hemoglobin(OR 1.821,95％CI 1.028-3.225,P=0.040)were the independent risk factors for low dose RTX selection,and proteinuria ≥8 g/24 h(OR 5.854,95％CI 1.247-27.482,P=0.025)was the independent risk factors of treatment no-remission.Conclusion The efficacy of low dose RTX is not inferior to that of standard dose RTX in the short term.For patients with anemia and renal dysfunction,doctors tend to choose low dose RTX to treat PMN.
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