Contribution of residual function to removal of protein-bound solutes in hemodialysis.

Background And Objectives: This study evaluated the contribution of residual function to the removal of solutes for which protein binding limits clearance by hemdialysis.

Design, Setting, Participants, & Measurements: Solute concentrations were measured in 25 hemodialysis patients with residual urea clearances ranging from 0.1 to 6.

Hemoglobinuria and acute kidney injury requiring hemodialysis following intravenous immunoglobulin infusion.

Intravenous immunoglobulin (IVIG), a product initially developed for patients with immunodeficiencies, now has multiple other indications and increasing off-label use. IVIG generally is well tolerated, with few adverse effects. Antibody-mediated (Coombs-positive) hemolysis is known to occur after IVIG infusion, but often is subclinical and previously has not been reported to lead to acute kidney injury (AKI).