BRIEF RESEARCH REPORT article
Front. Pharmacol.
Sec. Renal Pharmacology
Acute post-infusion Hypokalemia Following Rituximab therapy in Patients with Nephrotic Syndrome: Case Series and literature review
Provisionally accepted
- 1Lishui Central Hospital, Lishui, China
- 2Longquan People's Hospital, lishui, China
- 3Liandu District Baiyun Street Community Health Service Center, lishui, China
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Background: Rituximab has become an important therapeutic option for nephrotic syndrome (NS), and its adverse event profile is generally well characterized. However, reports of acute hypokalemia specifically occurring in the post-infusion period remain rare. We aimed to present and analyze cases of this distinct timing of electrolyte disturbance. Case Presentation: This case series describes two adult patients with NS who developed acute, severe hypokalemia in the hours immediately following a rituximab infusion. Case 1: A 20-year-old male with steroid-dependent minimal change disease developed progressive quadriceps weakness and severe hypokalemia (potassium 1.79 mmol/L) several hours after his fifth rituximab infusion. His previous four infusions had been uneventful. Case 2: A 46-year-old male with membranous nephropathy presented with marked mental fatigue and severe hypokalemia (potassium 2.34 mmol/L) shortly after his sixth cumulative rituximab infusion, following five prior tolerated infusions. Common precipitants of hypokalemia were absent. Both patients responded promptly to potassium supplementation, with full symptomatic recovery and normalization of serum potassium. Conclusion: Severe hypokalemia can occur acutely after rituximab infusion in NS, even after prior uneventful exposures. Presentations may
Keywords: Adverse Drug Reaction, case report, Hypokalemia, Nephrotic Syndrome, rituximab
Received: 18 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Huang, Yu, Jin, Wu, Xu, Xiang and Lei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenhui Lei
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