Effect of IVIG Treatment on Renal Function in Neonates

ABSTRACT

This study was conducted to evaluate the effect of intraveneous immunoglobulin (IVIG) infusion on renal function in neonates. IVIG has provided quite safe in neonates given therapeutic doses. But nephrotoxicity is not a recognized adverse events of IVIG therapy, only several previous adult cases having been described. A total twenty five neonates suspected sepsis was randomely assigned to IVIG (n=12) or control (n=13) group. Neonates assigned to IVIG group received IVIG (1g/kg, 1 dose) adjunct to ampicillin and gentamicin, and neonates assigned to control group received same antibiotics. To observe changes in renal function with IVIG therapy, serum BUN, creatinine, urine creatinine, beta2-microglobulin ( beta2MG) and N-acetyl-beta-D-glucosam-inidase (NAG) were obtained before and 24 hours, 3 and 7 days after initiation of therapy. There were no statistically significant changes in serum BUN and creatinine in both groups. Transient increase of urine NAG was observed at 24 hours after therapy in IVIG group. Urine beta2MG of IVIG group remained in pretreatment level, whereas decreased with age in control group, so, at 7th day IVIG group have higher urinary excretion of beta2MG compared to control group. According to these results, it was found that IVIG therapy in neonates might cause transient renal tubular damage.