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Ibuprofen in very preterm infants impairs renal function for the first month of life

Rachel Vieux1, Roxane Desandes, Farid Boubred

  • 1Maternite Regionale, Neonatal Department, Nancy-University, Nancy, France. r.vieux@maternite.chu-nancy.fr

Pediatric Nephrology (Berlin, Germany)
|November 11, 2009
PubMed

Insights

Ibuprofen treatment for patent ductus arteriosus (PDA) in preterm infants significantly reduces glomerular filtration rate (GFR) and impairs tubular function during the first month of life. Careful renal monitoring is advised for these infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Nephrology
  • Pharmacology

Background:

  • Patent ductus arteriosus (PDA) is common in very preterm infants.
  • Ibuprofen is a common treatment for PDA, but its renal effects are not fully understood.
  • Assessing renal function is crucial in this vulnerable population.

Purpose of the Study:

  • To determine the renal effects of ibuprofen treatment for PDA in very preterm infants.
  • To evaluate changes in glomerular and tubular function during the first month of life.
  • To establish the association between ibuprofen administration and renal function in neonates.

Main Methods:

  • A cohort study involving 148 infants (27-31 weeks gestation) treated for PDA.
  • Infants were grouped based on ibuprofen exposure.
  • Renal function, including glomerular filtration rate (GFR), was assessed weekly for one month via echocardiography and laboratory tests.

Main Results:

  • Ibuprofen-treated infants showed a significant decrease in GFR after treatment withdrawal (Day 7: 12.8 vs. 18.1 ml/min/1.73 m²).
  • This reduction in GFR was sustained throughout the first month of life.
  • Impaired tubular function was also observed in infants receiving ibuprofen.

Conclusions:

  • Ibuprofen administration for PDA is linked to decreased GFR and impaired renal function in very preterm infants.
  • Close monitoring of renal function is recommended for infants treated with ibuprofen.
  • Caution is advised when administering drugs eliminated by glomerular filtration in these infants.

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