Q J Med 2000; 93: 751-755
© 2000 Association of Physicians
Nephrotoxicity of intravenous immunoglobulin
From the Renal Section, Division of Medicine, Imperial College School of Medicine, Hammersmith Hospital, London, UK
Received 7 June 2000 and in revised form 11 September 2000
Individual case reports have documented nephrotoxicity of intravenous immunoglobulin (IVIG) preparations, but the true incidence of renal dysfunction is unknown and many data sheets do not include renal impairment as a side-effect of these preparations. We determined the incidence of renal impairment in an unselected cohort of patients receiving two different preparations of IVIG over 20 months, administering 287 courses of IVIG to 119 patients for a variety of indications, including thrombocytopenia, systemic lupus erythematosis, neuropathy, Guillain-Barre syndrome and infections. Two different preparations of IVIG were used, Vigam (BPL) and Sandoglobulin (Novartis), which differ in the concentration of sucrose added as a stabilizer. Eight patients showed deterioration in renal function (6.7%), and in two, no renal recovery occurred (1.7%). There were no significant differences in the patient characteristics or dose or preparation of IVIG administered to those patients with or without changes in serum creatinine. There was no association between the amount of sucrose in the IVIG and development of renal failure. IVIG (regardless of the sucrose content) is associated with renal impairment which may be irreversible, with a maximum incidence of 6.7%. All patients should have their renal function monitored during the use of IVIG.
Address correspondence to Dr J.B. Levy, Renal Section, Division of Medicine, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0NN. e-mail: j.levy{at}ic.ac.uk
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. Bollee, D. Anglicheau, A. Loupy, J. Zuber, N. Patey, D. M. Gregor, F. Martinez, M.-F. Mamzer-Bruneel, R. Snanoudj, E. Thervet, et al. High-Dosage Intravenous Immunoglobulin-Associated Macrovacuoles Are Associated with Chronic Tubulointerstitial Lesion Worsening in Renal Transplant Recipients Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1461 - 1468. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Akhtar and B. Bastani Acute Renal Failure and Myocarditis Associated with Intravenous Immunoglobulin Therapy Ann Intern Med, August 19, 2003; 139(4): W-65 - W-65. [Full Text] [PDF]
|
|
|
|
 |
|
 N P S BAJAJ, N HENDERSON, R BAHL, K STOTT, and R E CLIFFORD-JONES Call for guidelines for monitoring renal function and haematological variables during intravenous infusion of immunoglobulin in neurological patients J. Neurol. Neurosurg. Psychiatry, October 1, 2001; 71(4): 562 - 563. [Full Text]
|
|