Chronic kidney disease in adults with primary immunodeficiency diseases in treatment with intravenous immunoglobulin
PDF (Spanish)
PubMed

Supplementary Files

XML (Spanish)

Keywords

Common variable immunodeficiencies
Humoral immune response
Intravenous immunoglobulin
Chronic renal failure

Abstract

Background: Intravenous immunoglobulin (IVIG) is the treatment of choice for humoral primary immunodeficiency diseases (PIDs). A third of the patients who receive intravenous immunoglobulin have adverse reactions, such as osmotic nephrosis.

Objective: To assess the presence of kidney disease in adults with humoral PIDs, in treatment with intravenous immunoglobulin.

Methods: A cross-sectional, descriptive, and observational study of patients who belong to the PID Clinic of the Specialties Hospital of the National Medical Center “Siglo XXI”, Mexico City, who receive treatment with intravenous immunoglobulin. A questionnaire with demographic information, 24h urine creatinine clearance, serum creatinine, urea, and BUN (Blood Urea Nitrogen) was applied.

Results: 35 patients were surveyed; 65.7 % were women; the average age was 34 years; 51.4 % of the patients presented kidney damage. Those with > 5 years of treatment with intravenous immunoglobulin presented chronic kidney disease (CKD) with more frequency (55.6 %) according to the KDOQI scale.

Conclusions: Chronic kidney disease occurs in 51 % of adult patients with PID who have been treated with intravenous immunoglobulin for more than 5 years; which is why these patients require periodic evaluations of their kidney function, and the use of sugar-free immunoglobulin in order to reduce the risk.

PDF (Spanish)
PubMed

References

Hernández-Martínez C, Espinosa-Rosales F, Espinosa-Padilla SE, Hernández-Martínez AR, Blancas-Galicia L. Conceptos básicos de las inmunodeficiencias primarias. Rev Alerg Mex. 2016;63(2):180-189. DOI: 10.29262/ram.v63i2.146

Bousfiha A, Jeddane L, Picard C, Ailal F, Bobby-Gaspar H, Al-Herz W, et al. The 2017 IUIS phenotypic classification for primary immunodeficiencies. J Clin Immunol. 2018;(38):129-143. DOI: 10.1007/s10875-017-0465-8

Fischer A, Rausell A. What do primary immunodeficiencies tell us about the essentiality/redundancy of immune responses? Semin Immunol. 2018;(36):13-16. DOI: 10.1016/j.smim.2017.12.001

Srinivasa BT, Alizadehfar R, Desrosiers M, Shuster J, Pai NP, Tsoukasa CM. Adult primary immune deficiency: What are we missing? Am J Med. 2012;125(8):779-786. DOI: 10.1016/j.amjmed.2012.02.015

European Society for Primary Immunodeficiencies. ESID Registry-Working definitions for clinical diagnosis of PID. Italia: ESID; 2019. Disponible en: https://esid.org/content/download/16628/452872/file/ESIDRegistry_ClinicalCriteria.pdf

Bonilla FA, Barlan I, Chapel H, Costa-Carvalho BT, Cunningham-Rundles C, Espinosa-Rosales FJ, et al. International Consensus Document (ICON): Common variable immunodeficiency disorders. J Allergy Clin Immunol Pract. 2016;4(1):38-59. DOI: 10.1016/j.jaip.2015.07.025

Aucouturier P, Mariault M, Lacombe C, Preud´homme JL, Frequency of selective IgG subclass deficiency: A reappraisal. Clin Immunol Immunopathol. 1992;63(3):289-291. DOI: 10.1016/0090-1229(92)90236-h

Herrod HG, Clinical significance of IgG subclases. Curr Opin Pediatr. 1993;5(6):696-699. DOI: 10.1097/00008480-199312000-00010

Espinosa-Rosales FJ, Bergés-García A, Coronado- Zarco IA, Dávila-Gutiérrez G, Faugier-Fuentes E, García-Campos JA, et al. Consenso mexicano para la prescripción de inmunoglobulina G como tratamiento de reemplazo e inmunomodulación. Acta Pediatr Mex. 2018;39(2):134-171. DOI: 10.18233/apm39no2pp134-1711574

Ballow, M. Practical aspects of immunoglobulin replacement. Ann Allergy Asthma Immunol. 2017;119(4):299-303. DOI: 10.1016/j.anai.2017.07.020

Orange JS, Hossny EM, Weiler CR, Ballow M, Berger M, Bonilla FA, et al. Use of intravenous immunoglobulin in human disease: a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. J Allergy Clin Immunol. 2006;117(Suppl 4):S525-S553. DOI: 10.1016/j.jaci.2006.01.015

Goudouris ES, Rego Silva AM, Ouricuri AL, Grumece AS, Condino-Neto A, Costa-Carvalho BT, et al. II Brazilian Consensus on the use of human immunoglobulin in patients with primary immunodeficiencies. Einstein (Sao Paulo). 2017;15(1):1-16. DOI: 10.1590/S1679-45082017AE3844

Dantal J. Intravenous immunoglobulins: in-depth review of excipients and acute kidney injury risk. Am J Nephrol. 2013;38(4):275-284. DOI: 10.1159/000354893

Kaveri SV, Lecerf M, Saha C, Kazatchkine MD, Lacroix-Desmazes S, Bayry J. Intravenous immunoglobulin and immune response. Clin Exp Immunol. 2014;178(Suppl 1):94-96. DOI: 10.1111/cei.12526

Guo Y, Tian X, Wang X, Xiao Z. Adverse effects of immunoglobulin therapy. Front Immunol. 2018;9:1299. DOI: 10.3389/fimmu.2018.01299

Caress JB, Kennedy BL, Eickman KD. Safety of intravenous immunoglobulin treatment. Expert Opin. Drug Saf. 2010;9(6): 971-979. DOI: 10.1517/14740338.2010.484419

Marie I, Cherin O, Michaellet M, Pelus E, Dantal J, Crave JC, et al, Management of adverse effects related to human immunoglobulin therapy: recommendations for clinical practice. Rev Med Interne. 2017;38(5):312-319. DOI: 10.1016/j.revmed.2016.10.390

Levine AA, Levine TD, Clarke K, Saperstein D. Renal and hematologic side effects of long-term intravenous immunoglobulin therapy in patients with neurologic disorders. Muscle Nerve. 2017;56(6):1173-1176. DOI: 10.1002/mus.25693

Lin RY, Rodríguez-Baez G, Bhargave GA, Lin H. Intravenous gammaglobulin-associated renal impairment reported to FDA: 2004-2009. Clin Nephrol. 2011;76(5):365-372. DOI: 10.5414/cn106824

Rodríguez-Mireles KA, Galguera-Sauceda A, Gaspar-López A, López-Rocha EG, Campos-Romero FH, del Rivero-Hernández LG, et al. Efectos adversos de la aplicación ambulatoria de inmunoglobulina intravenosa en adultos con inmunodeficiencia común variable, Rev Alerg Mex. 2014;61(3):131-140. DOI: http://dx.doi.org/10.29262/ram.v61i3.37

Gaspar-López A, Miranda-Novales MG, López-Rocha EG, Rodríguez-Mireles KA, Segura-Méndez NH. Estimación de la tasa de filtración glomerular en adultos con inmunodeficiencia común variable tratados con inmunoglobulina intravenosa. ¿Qué fórmula utilizar? Rev Alerg Mex. 2014;61(2):45-51. DOI: http://dx.doi.org/10.29262/ram.v61i2.25

Levin A, Stevens PE, Bilous RW, Coresh J, de Francisco ALM, Griffith KE, et al. Kidney disease: Improving Global Outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-150. DOI: 10.1038/kisup.2012.73

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright (c) 2020 Revista Alergia México

Downloads

Download data is not yet available.