Intravenous immunoglobulin-induced osmotic nephrosis

Nasimul Ahsan, Biff F. Palmer, Don Wheeler, Ralph G. Greenlee, Robert D. Toto

Research output: Contribution to journalArticle

90 Scopus citations

Abstract

Intravenous immunoglobulin preparations are being used for an increasing number of indications in clinical medicine. To minimize adverse reactions, sugar additives such as sucrose are added to some preparations to serve as stabilizing agents. We describe a patient treated with an immunoglobulin preparation containing sucrose who developed a fully reversible form of acute renal failure with histologic changes characterized by vacuolization and swelling of renal proximal tubular cells. We believe the high concentration of sucrose in the immunoglobulin preparation resulted in osmotic injury to the renal tubules. Such changes, which are identical to those described in humans and experimental animals given intravenous infusions of hypertonic sucrose, have come to be known as osmotic nephrosis. Risk factors for the development of this lesion are renal insufficiency and volume depletion. The risk for such injury can be minimized by further diluting the immunoglobulin preparation and slowing the infusion rate.

Original languageEnglish (US)
Pages (from-to)1985-1987
Number of pages3
JournalArchives of Internal Medicine
Volume154
Issue number17
DOIs
StatePublished - Sep 12 1994

ASJC Scopus subject areas

  • Internal Medicine

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