{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:18:02Z","timestamp":1787642282080,"version":"build-2736575974"},"reference-count":26,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kidney Dis"],"abstract":"<jats:p>&lt;p&gt;Introduction: Rituximab (RTX) is a key therapeutic agent for maintaining remission in steroid-dependent nephrotic syndrome and frequently relapsing nephrotic syndrome, demonstrating both efficacy and safety. However, reliable biomarkers for predicting relapse remain under investigation. Methods: This single-center, retrospective, observational study included 70 patients who received RTX between January 2015 and January 2023. Patients were classified into two groups: the non-relapse group and the relapse group. Cox proportional hazards regression was used to analyze the associations between baseline clinical parameters and relapse risk, while Kaplan-Meier survival analysis was performed to estimate the recurrence-free survival rates. Results: This cohort of 70 pediatric patients (71.4% male; median age: 9.5 years, interquartile range: 8.5\u201312.6) exhibited a 24-month post-rituximab relapse rate of 32.9% (23\/70). Multivariate analysis identified elevated baseline memory B-cell levels (adjusted hazard ratio [HR] = 1.103, 95% confidence interval [CI]: 1.045\u20131.164, p &lt; 0.001), reduced baseline natural killer (NK) cell levels (adjusted HR = 0.866, 95% CI: 0.752\u20130.997, p = 0.045), and higher IgG levels at 3 months post-RTX (adjusted HR = 1.245, 95% CI: 1.080\u20131.435, p = 0.003) as independent predictors of relapse. Kaplan-Meier survival analysis revealed that patients with memory B-cell counts below 19.65% of baseline (n = 38) had significantly higher 24-month relapse-free survival compared to those with counts above this threshold (n = 32; 86.8% vs. 43.8%; \u03c72 = 13.918, p &lt; 0.001). In contrast, patients with NK-cell levels below 6.45% of lymphocytes (n = 25) exhibited poorer 24-month relapse-free survival than those with higher NK-cell proportions (n = 45; 52.0% vs. 77.8%; \u03c72 = 6.395, p = 0.011). Similarly, patients with IgG levels below 5.74 g\/L (n = 35) demonstrated significantly better relapse-free survival compared to those with higher levels (n = 35; 85.3% vs. 47.2%; \u03c72 = 11.030, p = 0.001). Conclusion: Baseline memory B-cell and NK-cell levels (pre-RTX), as well as IgG levels at 3 months post-RTX, were identified as predictive biomarkers for the 2-year relapse risk following RTX therapy. These findings may contribute to the development of personalized RTX treatment strategies. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000548505","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:15:54Z","timestamp":1765358154000},"page":"712-721","source":"Crossref","is-referenced-by-count":2,"title":["Identification of Risk Factors for Relapse following Rituximab Therapy in Children with Steroid-Sensitive Nephrotic Syndrome"],"prefix":"10.1159","volume":"11","author":[{"given":"Chen","family":"Ling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Xi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hejia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9724-6493","authenticated-orcid":false,"given":"Xiaorong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-029249"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14184-0"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021111472"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.728010"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.08570722"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.06.013"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2015050523"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-024-06622-z"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.021"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00377"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-022-05739-3"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-024-02484-9"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021050643"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-012-1913-3"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-023-02374-6"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01653"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-019-04398-1"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-015-3197-0"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2023.03.002"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-017-1415-8"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-018-0088-7"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2023.156437"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfae228"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-021-05304-4"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-023-06124-4"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2314471"}],"container-title":["Kidney Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000548505","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:15:57Z","timestamp":1765358157000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000548505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000548505","archive":["Portico"],"relation":{},"ISSN":["2296-9381","2296-9357"],"issn-type":[{"value":"2296-9381","type":"print"},{"value":"2296-9357","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]}}}