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Perinatal drug exposure and renal function in very preterm infants

R Vieux1, J Fresson, F Guillemin

  • 1Maternité Régionale, Neonatal Department, Nancy, France. r.vieux@maternite.chu-nancy.fr

Archives of Disease in Childhood. Fetal and Neonatal Edition
|December 22, 2010
PubMed

Insights

Ibuprofen was found to be nephrotoxic in very preterm infants, impacting glomerular filtration rate (GFR) for up to one month. Physicians should monitor GFR in infants treated with ibuprofen, as drug clearance may remain reduced.

Area of Science:

  • Neonatal Medicine
  • Pharmacology
  • Nephrology

Background:

  • Very preterm infants are vulnerable to kidney injury.
  • Assessing the nephrotoxic potential of commonly prescribed drugs is crucial for this population.

Purpose of the Study:

  • To evaluate the impact of first-week-of-life medications on glomerular filtration rate (GFR) and tubular function in very preterm infants.

Main Methods:

  • Prospective multicentre cohort study involving infants born between 27-31 weeks gestation.
  • GFR measured on day 2 and weekly for 1 month using a standardized kinetic Jaffe method.
  • Infants categorized into 'Low GFR' and 'High GFR' groups based on day 7 GFR relative to gestational age median.

Main Results:

  • 269 infants analyzed; 183 in 'Low GFR' and 86 in 'High GFR' group.
  • Higher incidence of ibuprofen use in the 'Low GFR' group (30.0%) compared to the 'High GFR' group (17.4%).
  • Aminoglycosides, glycopeptides, and other common drugs showed no significant nephrotoxic effect at therapeutic doses.

Conclusions:

  • Ibuprofen was the only drug identified as nephrotoxic in very preterm infants during the 1-month follow-up.
  • Reduced GFR post-ibuprofen treatment may persist for the first month, affecting drug clearance.
Abstract

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