Rituximab and Targeted Nursing for Pediatric Nephrotic Syndrome

Inclusion Criteria: * Diagnosis of primary pediatric nephrotic syndrome, specifically steroid-dependent nephrotic syndrome (SDNS) or frequently relapsing nephrotic syndrome (FRNS), as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. (SDNS is defined as relapse occurring during tapering of glucocorticoids or within 14 days of discontinuation; FRNS is defined as ≥2 relapses within 6 months of initial response or ≥4 relapses in any 12-month period). * Age between 6 and 15 years. * Normal intellectual development and the ability to understand and communicate. * Informed consent obtained from the guardians and assent from children capable of understanding. Exclusion Criteria: * Steroid-resistant nephrotic syndrome (SRNS). * Severe renal insufficiency (according to KDIGO criteria or other relevant standards). * Cognitive or mental disorders. * Worsening condition upon admission necessitating intensive care. * Parents unable to provide long-term care or unwilling to participate. * Interruption of hospitalization for any reason. * Prior treatment with rituximab or tacrolimus. * Co-existing significant kidney, urinary system diseases (other than NS), or severe active urinary tract infection. * Significant liver function impairment. * Known hypersensitivity to rituximab or tacrolimus.