Nephrotoxicity of intravenous immunoglobulin

Individual case reports have documented nephrotoxicity of intravenous immun oglobulin (IVIG) preparations, but the true incidence of renal dysfunction is unknown and many data sheets do not include renal impairment as a side-e ffect of these preparations. We determined the incidence of renal impairmen t in an unselected cohort of patients receiving two different preparations of IVIC over 20 months, administering 287 courses of IVIG to 119 patients f or a variety of indications, including thrombocytopenia, systemic lupus ery thematosis, neuropathy, Guillain-Barre syndrome and infections. Two differe nt 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 ren al recovery occurred (1.7%). There were no significant differences in the p atient characteristics or dose or preparation of IVIG administered to those patients with or without changes in serum creatinine. There was no associa tion between the amount of sucrose in the IVIG and development of renal fai lure. IVIG (regardless of the sucrose content) is associated with renal imp airment which may be irreversible, with a maximum incidence of 6.7%. All pa tients should have their renal function monitored during the use of IVIG.