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vation in childhood steroid-sensitive nephrotic syndrome. Clin Nephrol 2003; 60: 242–247 31. Sfikakis PP, Boletis JN, Lionaki S et al. Remission of proliferative lupus nephritis following B cell depletion therapy is preceded by down-regulation of the T cell costimulatory molecule CD40 ligand: an open-label trial. Arthritis Rheum 2005; 52: 501–513 32. Fervenza FC, Abraham RS, Erickson SB et al. Rituximab therapy in idiopathic membranous nephropathy: a 2-year study. Clin J Am Soc Nephrol 2010; 5: 2188–2198 33. Hultin LE, Hausner MA, Hultin PM et al. CD20 (pan-B cell) antigen is expressed at a low level on a subpopulation of human T lymphocytes. Cytometry 1993; 14: 196–204 34. Sahali D, Pawlak A, Le Gouvello S et al. Transcriptional and post-transcriptional alterations of IkappaBalpha in active minimal-change nephrotic syndrome. J Am Soc Nephrol 2001; 12: 1648–1658 35. Martin F, Chan AC. Pathogenic roles of B cells in human autoimmunity; insights from the clinic. Immunity 2004; 20: 517–527 36. Ishimoto T, Shimada M, Araya CE et al. Minimal change disease: a CD80 podocytopathy? Semin Nephrol 2011; 31: 320–325 37. Fornoni A, Sageshima J, Wei C et al. Rituximab targets podocytes in recurrent focal segmental glomerulosclerosis. Sci Translat Med 2011; 3: 85ra46 38. Calabrese LH, Molloy ES, Huang D et al. Progressive multifocal leukoencephalopathy in rheumatic diseases: evolving clinical and pathologic patterns of disease. Arthritis Rheum 2007; 56: 2116–2128 39. Glassock RJ. Therapy of relapsing minimal-change disease in adults: a new approach? Kidney Int 2013; 83: 343–345

Fistula-first and catheter-last: fading certainties and growing doubts