Nephrotoxicity of intravenous immunoglobulin

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 impairmen...

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Bibliographic Details
Published in:QJM : An International Journal of Medicine 2000-11, Vol.93 (11), p.751-755
Main Authors: Levy, J.B., Pusey, C.D.
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Creatinine - blood
Drug toxicity and drugs side effects treatment
Excipients - adverse effects
Female
Humans
Immunoglobulins, Intravenous - adverse effects
Kidney Diseases - blood
Kidney Diseases - chemically induced
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Retrospective Studies
Sucrose - adverse effects
Toxicity: urogenital system
Treatment Outcome
Citations: Items that cite this one
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Summary: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.
ISSN:1460-2725
1460-2393
1460-2393
DOI:10.1093/qjmed/93.11.751