Kidney Week

Abstract: SA-PO0777

Obinutuzumab for Treatment of Proliferative Lupus Nephritis in Severe Kidney Failure: A Report of Two Cases

Session Information

• Glomerular Diseases: Lupus Nephritis, Monoclonal Gammopathy-Related Disease, and Transplantation
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Ortuño Moreno, Nohelia María, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico

Nohelia María Ortuño Moreno, MD

• Barrientos Feria, Sarai Ruth, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico

Sarai Ruth Barrientos Feria, MD

• Villanueva-Perez, Arisbeth, Instituto Mexicano del Seguro Social, Mexico City, CDMX, Mexico

Arisbeth Villanueva-Perez, MD

• Garcia-Flores, Octavio Rene, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico

Octavio Rene Garcia-Flores, MD

• Vasquez Jiménez, Enzo Christopher, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico

Enzo Christopher Vasquez Jiménez, MD

Introduction

Obinutuzumab a humanised, type II anti-CD20 monoclonal antibody that has a distinct mode of binding to the CD20 antigen compared with type I anti-CD20 antibodies and is glycoengineered for greater affinity for the FcγRIII on effector cells. Obinutuzumab plus standard therapy has been shown to be more effective than standard therapy alone in achieving a complete kidney response. However, this evidence has been shown in patients with GFR > 30 ml/min/1.73m2. In this report, we show the preliminary clinical outcomes in patients with significant deterioration of kidney function due to proliferative lupus nephritis.

Case Description

Case 1. A 20-year-old female, who presented with nephrotic syndrome, massive proteinuria, and severe impairment of kidney function, requiring hemodialysis. Kidney biopsy showed class IV lupus nephritis with an activity index of 10. She received induction with obinutuzumab, achieving discontinuation of hemodialysis at three months and improvement of creatinine to 1.7 mg/dL (Table 1).
Case 2. A 38-year-old male patient who presented with nephrotic syndrome and severe impairment of kidney function (creatinine 4.59 mg/dL). The kidney biopsy reported class IV + V lupus nephritis with an activity index of 14. Induction therapy with obinutuzumab was started, observing significant improvement in kidney function after months, with creatinine of 1.5 mg/dL and proteinuria less than 3.5 g/g (Table 1).

Discussion

Obinutuzumab as induction therapy for patients with proliferative lupus nephritis with significant impairment of kidney function and GFR < 30 ml/min/1.73m2 shows favorable clinical and kidney outcomes. Follow-up at 6 months and one year is ongoing.