What potential cause of renal insufficiency can occur when treating patients with IVIG?

When treating patients with intravenous immunoglobulin (IVIG), one of the potential causes of renal insufficiency is hyperosmolar renal damage induced by the breakdown of sucrose. IVIG products often contain stabilizers, among which sucrose is frequently used. When given intravenously, sucrose can contribute to hyperosmolarity and potentially lead to tubular damage in the kidneys. This is particularly problematic in patients who may already have compromised renal function or are at risk for renal insufficiency. The hyperosmolar state can cause alterations in renal blood flow and glomerular filtration rate, leading to further renal injury.

The other options, while they may pertain to renal issues in different contexts, do not have the same direct association with IVIG therapy as the hyperosmolar renal damage due to sucrose breakdown. Renal artery stenosis and chronic renal failure due to hypertension concern more structural or chronic disease states rather than an acute response related to IVIG administration. Acute tubular necrosis from rhabdomyolysis is typically associated with muscle breakdown rather than a direct effect of IVIG. Thus, the relevant and direct link to renal insufficiency in the context of IVIG treatment is the hyperosmolar renal damage stemming from sucrose breakdown.