There are two purposes for writing this article: I would like to thank Professor Zhang Yimin from Zhongshan Sixth Hospital. Professor Zhang has superb medical skills and noble medical ethics, and has controlled my father's nephrotic syndrome;

There are two purposes for writing this article:

(1) Thanks to Professor Zhang Yimin from Zhongshan Sixth Hospital. Professor Zhang has superb medical skills and noble medical ethics and has controlled my father's nephrotic syndrome (the symptoms have improved significantly);

(2 ) would like to share my father’s treatment process for nephropathy with rituximab, so as to serve as a reference for many patients, and hope that more patients can receive effective treatment.

01 In May last year, my father was diagnosed with nephrotic syndrome

My father is 72 years old this year. He and his mother live in his hometown (a county in northern Anhui)

Around May 2021, my father felt swollen legs and feet. (Cannot put on shoes), general weakness

I went to the county hospital for a checkup, and the test result was nephrotic syndrome, with a PLA2R of more than 250 (normal people should be below 14);

The county hospitaldiagnosis was membranous nephropathy

My father was hospitalized For a week, the doctor only gave me diuretic drugs, which reduced my father's edema.

I communicated with the doctor. The doctor said that the only way to completely cure the disease was chemotherapy (cyclosporine + hormones).

But he was worried about my father's age. It was big, and my father had suffered a femoral fracture before, so he didn’t dare to use it. In the end, we chose conservative treatment and hoped to go home and rest in a week.

The doctor prescribed diuretic medicine and told my father to go to the hospital for a check-up once a month.

02 Half a year later, my father's condition became serious.

After my father returned home, he took diuretic medicine every day. There was no special feeling.

There was no edema. The first After one month's checkup, it seemed that there was still some improvement.

The urine protein changed from 4+ to 3+

. However, during the second month's checkup, the urine protein returned to 4+

. The doctor told him to stop taking the diuretic medicine (3 I only learned a few months ago that diuretic drugs are not helpful in treating kidney disease, but damage the kidneys);

At that time, the doctor also made it clear that there was basically no other way without hormones + chemotherapy.

The risk of using it was also very high, because my father was too old. .

Just like this, my father stayed at home for half a year. Around the Spring Festival, my father's illness became more and more serious.

His edema was severe, and there was no way to go to the county hospital to see a doctor. .

03 The long road to seek medical treatment

When I returned home during the Spring Festival, I felt very sad when I saw my father’s condition (my father usually wouldn’t tell me the truth on the phone);

He felt that there was no way to go to the hospital to find a doctor;

I went back When I got to work, I started to consult online about the treatment plan for membranous nephropathy.

The result of the initial consultation was the same as that of our county hospital.

(1) Preliminary understanding of the treatment of kidney disease with rituximab

Later, I consulted online Professor Xu Rong from Peking University First Hospital Professor Zhang Yimin from Sun Yat-sen University Sixth Hospital,

They all told me that I can use rituximab for my father. To treat the disease,

Rituxan has much less side effects, so my father’s situation should be acceptable.

Both professors emphasized that you must use 1 gram at a time, and then use 1 gram after 14 days, otherwise the effect will not be good.

I see hope for my father's treatment.

(2) The tortuous road to seek medical treatment

Because it is far away from Beijing and Guangzhou (coupled with the epidemic factor)

I began to consider where to treat my father

I went first to Anhui Provincial Hospital , and the doctor prescribed it to my father after examination. Hospitalization form;

My father was asked to wait for a bed at home, but due to some unforeseen circumstances, my father was not admitted to the hospital for a month (due to the epidemic, and the hospital’s service attitude was average);

I was really helpless, so I wanted to bring my father to the city where I work. See a doctor (always better than spending money at home);,

I consulted three tertiary hospitals in the city, , and they all said they could treat my father's disease.

I chose a hospital with the strongest capabilities and communicated with the doctor. Their hospital can use rituximab treatment,

(3) The first treatment failed

My father had severe edema at the time, so the hospital gave him surgery Full body examination

and renal puncture performed on my father on the fourth day (Professor Zhang from Zhongshan Sixth Hospital was opposed to renal puncture. After what happened, I think Professor Zhang was right).

The results of the renal puncture came out a week later. It was revealed that my father had membranous nephropathy and the kidney matrix was damaged. The comprehensive assessment was that he was in stage 4 kidney disease.

Taking into account my father's comprehensive condition, the doctor also suggested using Rituximab to treat

At that time, the doctor was worried that my father's body could not bear it.

Planned to give him 0.2g-0.3g (The director of the Department of Nephrology was worried that the more treatment he had, the more serious his condition would be. Dare not take medicine);

After my father was hospitalized for nearly 24 days, I gave him treatment for the first time, infusion of Rituximab (Hanlikan);

About 30 minutes after infused , my father screamed and became cold all over, and then developed a fever. to 38 degrees.

The hospital treated him urgently, stopped the infusion, and gave him a fever-reducing injection. An hour later, my father’s body temperature returned to normal.

I communicated with the attending doctor the next day, and they made it clear that they did not dare to use rituximab (they said it was also the first time they had encountered my father's situation).

The doctor gave me two suggestions: (1) use conventional therapy: cyclosporine + hormone (halved); (2) discharge from hospital and go to Wuhan to listen to the opinions of Tongji and Union Medical College Hospital;

Unfortunately, I went to the West Campus of Union Medical College Hospital, Tongji Hospital , the professor looked at my father’s medical records

and thought that my father was not suitable for rituximab, and suggested using the traditional chat method.

However, the professor at Tongji Hospital issued a hospitalization order for my father and asked us to go to Tongji Hospital's Sino-French New City Campus to be hospitalized.

We rushed over excitedly and got the answer that there were no beds and we didn't know when beds would be available.

04 There is no way out, but there is a bright future in another village.

After returning from Wuhan, my father was in a very low mood, because Tongji Hospital in Wuhan did not have a good treatment.

He was going to go back to his hometown to suffer, but he was unwilling to give up the treatment.

, so he contacted Zhongshan Sixth Professor Zhang Yimin from the hospital,

I sent my father’s discharge report to Professor Zhang. Professor Zhang said there was no problem and he could be treated.

Because of the hospitalization problem, I suffered too much.

I was particularly worried about not being able to stay in the hospital after going to Guangzhou. Professor Zhang said that he can help.

Just like that, I took my father to the Sixth Hospital of Zhongshan Hospital in Guangzhou. Professor Zhang helped us arrange a ward, and my father stayed there.

My father was hospitalized for 3 days for examination. On the third day, all the examination reports came out.

My father took rituximab for the second time. This time he used imported rituximab ( Rituximab ).

Everything went well. Maybe it was due to his age. Because of this, Professor Zhang gave his father an infusion of 1 gram of medicine over two days.

After the infusion was completed, my father was discharged from the hospital.

14 days later, my father was hospitalized for the second time. In just 4 days, he completed the second 1-gram infusion.

All treatments are over.

I really didn’t expect that: doctors in the mainland were very worried and did not dare to give my father medicine. Professor Zhang from the Sixth Hospital of Zhongshan gave his father 1 gram of medicine in two days (almost all hospitals in the mainland did not dare to use it)

As of today, my father Nearly a month after he was discharged from the hospital, my father's edema has basically disappeared (there is still slight edema). I believe that as the medicine takes effect, my father's condition should be further relieved.

05 Written at the end

At this point, my father’s medical treatment process is basically over. When the results of the later reexamination come out, I will continue to update.

I have some insights about my father’s medical treatment process, and I would like to share them here.

(1) When a family member is sick, you must understand the condition clearly, because I knew nothing about my father’s kidney disease, which delayed my father’s illness for a year before receiving good treatment;

(2) If you contact a good hospital Or a doctor, don’t worry, go directly to the doctor. I went to 4 hospitals (municipal and provincial) to treat my father. At that time, the Zhongshan No. 6 Hospital was very efficient and effective. The previous hospitals could be said to have suffered and cost money. The key is no effect.

(3) The treatment cost for my father is about 45,000, including 32,000 for Rituximab, and about 13,000 for hospitalization and examination;

(4) If you or a relative has chronic kidney disease , you may wish to find a relatively excellent hospital in China for treatment. The effect may be much better.

Finally, I would like to express my gratitude again to Professor Zhang Yimin from Sun Yat-sen University, thank you!