IVIG and kidneys

[Debbie1]

We are headed for another round of IVIG next week. My husband had to look up something online regarding our insurance coverage and on the website under IVIG medications it says "Immune globulin can harm your kidneys". I had never heard this - has anyone else? Thanks.

[kimballot]

We are headed for another round of IVIG next week. My husband had to look up something online regarding our insurance coverage and on the website under IVIG medications it says "Immune globulin can harm your kidneys". I had never heard this - has anyone else? Thanks.

 

According to this article, http://www.cidpusa.org/glomerulonephritis.htm (page down to the bottom) nephrotoxicity is a rare but serious side effect of IVIG and this article seems to state that it is related to the amount of sucrose in the IVIG.

 

On the other hand, people with autoimmune disorders often have elevated levels of immune complexes and these can deposit in the kidneys and cause renal problems (glomerulonephritis). In those cases, IVIG is used to HELP the kidneys.

 

 

I guess the bottom line is that IVIG is serious stuff and is not without risks... and this is something to ask your doctor about to find out about the type of IVIG fluid that is being used with your child and the risks with that preparation.

[Debbie1]

Thanks. I do have a call in to the doctor and am waiting to hear back.

[kimballot]

Thanks. I do have a call in to the doctor and am waiting to hear back.

 

Perhaps it is something you can monitor with blood work? (like we monitor my son's liver functions every 6 weeks because of the antifungals that we use)

[amyjoy]

You monitor it before ivig with blood work that includes a general chemistry with kidney functions (BUN, creatinine, GFR). during the infusions, the child is infused with extra saline to help flush the kidneys during and after ivig. and afterwards, keeping your child well hydrated and just being watchful in case it looks like your child is not producing urine, is pretty much all you can do. its a rare complication, but certainly, aside from serious allergic reaction to the ivig itself during the procedure, the most serious complication.

[Debbie1]

Is the inability to produce urine the main symptom of this type of kidney problem? We did have the bloodwork done that was mentioned. Is this a problem that would happen immediately during or after IVIG or can it build up from multiple IVIGs?

[peglem]

We do IVIG every 3 to 4 weeks. 1.5g/kg and we do the whole infusion in one day. The nurses assess my daughter thoroughly before the infusion and check her vitals at least every 1/2 hour. When the infusion is finished we stay there for @ 1/2 hour to make sure everything is ok. We've not had any problems with it and started last March. Its important too, that the person administering the infusion has experience and knows how to check for and manage any possible adverse effects.