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[Acute renal failure after polyvalent immunoglobulin therapy]
M S Dilhuydy1, C Delclaux, V De Precigout
1Service de Néphrologie et d'Hémodialyse, CHU Pellegrin, Bordeaux.
Presse Medicale (Paris, France : 1983)
|June 16, 2000
Summary
Intravenous immunoglobulin therapy can cause acute renal failure, particularly in at-risk patients. Using sucrose-free preparations may help prevent kidney damage in these individuals.
Area of Science:
- Nephrology
- Immunology
Background:
- Intravenous immunoglobulin (IVIg) therapy is associated with acute renal failure (ARF).
- Patients with pre-existing risk factors for nephrotoxicity are particularly susceptible.
- ARF onset and resolution are typically rapid, though hemodialysis may be required.
Observation:
- Two cases of ARF following IVIg administration are presented.
- Case 1: A 76-year-old male with diabetes mellitus and hypertension.
- Case 2: A 77-year-old female using nonsteroidal anti-inflammatory drugs.
Findings:
- IVIg-induced ARF can occur in elderly patients with common comorbidities.
- Concomitant use of nephrotoxic agents like NSAIDs may increase risk.
- Sucrose-containing IVIg preparations are implicated in ARF.
Implications:
- Caution is advised when administering IVIg to patients with ARF risk factors.
- Screening for risk factors like diabetes, hypertension, and NSAID use is crucial.
- Employing sucrose-free IVIg formulations may mitigate nephrotoxicity risk.