AnonymousJune 15, 2007 at 2:05 pm
Last week I had a minor surgery for some endomitriosis. However, when they got in there they found that my kidney had some hydronephrosis and wound up transferring me from the surgery center to the hospital for a direct admit. I then had a second surgery on Thursday to insert a stent into kidney, ureter, and bladder until my ureter and kidney could heal itself from being damaged. This at least was the plan last week.
Today I got a call from the interventive radiologist and my c/t scan showed moderate kidney and ureter damage so I am getting a new kind of tube on Wednesday of next week. They also called my neurologist and she said no treatments while I have kidney issues. I was just starting to feel decent again with the treatments and can’t imagine going that downhill without my treatment. I am just sick.
Has anyone encountered this?
AnonymousJune 16, 2007 at 9:50 pm
Hopefully, your ivig treatments have not been the cause of your kidney troubles, but you previously mentioned in another thread that you recieve Carimune. My daughter also recieves this brand. Last year I looked at the precautions regarding ivig when my daughter was transfered to an infusion center where it was customary to infuse at a high rate, and Carimune was the only available option. Some things I learned:
*sucrose in ivig solution may cause kidney dysfunction/failure by overloading kidneys- reduced rate & concentration eases burden on kidneys
*osmolarity of solution contributes to kidney damage and/or thromboembolic events- to reduce osmolarity, use sterile water instead of saline solution
*paraproteinemia increases risk of renal failure
*migraines are thought to be an indicator for risk of aseptic meningitis
*Carimune is relatively high in sucrose and osmolarity (see chart in link below)
*GAMMAGARD LIQUID is the only 10% liquid IVIG solution drug product to contain no sugar, no sodium, no
preservatives, and provide latex-free packaging. (from CMS guidelines)
Here is the warning statement from the Carimune package insert:
Immune Globulin Intravenous (Human) (IGIV) products have been reported to be associated with renal
dysfunction, acute renal failure, osmotic nephrosis, and death (31–36).
Patients predisposed to acute renal failure include patients with:
1. any degree of pre-existing renal insufficiency
2. diabetes mellitus
3. age greater than 65
4. volume depletion
7. patients receiving known nephrotoxic drugs
In such patients, IGIV products should be administered at the minimum concentration available and the
minimum rate of infusion practicable. While these reports of renal dysfunction and acute renal failure
have been associated with the use of many of the licensed IGIV products, those containing sucrose as
a stabilizer accounted for a disproportionate share of the total number. See PRECAUTIONS and DOSAGE
AND ADMINISTRATION sections for important information intended to reduce the risk of acute renal
Perhaps your neurologist is willing to consider using another brand of ivig with a lower risk profile for kidney injury? Here is a comparison chart of the different brands (Nov 06):
Best wishes for a full recovery,
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