Abstract: Focal segmental glomerulosclerosis (FSGS) is a common glomerular disease leading to end stage renal disease, and podocyte injury is the main cause of it.The pathogenesis of podocyte injury in idiopathic FSGS is still unknown. Idiopathic FSGS is easy to relapse and the overall prognosis is poor，except for glucocorticoids and calcinurin inhibitors, there are still lack of effective treatments.Several literatures have reported that rituximab (RTX) can obtain beneficial effects in idiopathic FSGS. As a B cell depletion agent, how RTX plays a role in treatment of idiopathic FSGS, its immunological efficacy and cytoprotective mechanism are still being study. Therefore, based on the drug characteristics of RTX, this paper reviews the main clinical studies and related researches in the field of podocyte injury in recent years ,presenting the immunological mechanism and podocyte protective mechanism of RTX in the treatment of idiopathic FSGS.

Key words: rituximab, focal segmental glomerulosclerosis, B cell, podocytes, sphingomyelinphosphodiesterase-like 3b protein