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Indomethacin and renal function in premature infants with persistent patent ductus arteriosus
Insights
Indomethacin treatment significantly reduced kidney function in premature infants with patent ductus arteriosus, decreasing urine flow and ion excretion. Most renal functions recovered after discontinuing the drug.
Area of Science:
- Neonatal Medicine
- Pediatric Nephrology
- Pharmacology
Background:
- Patent ductus arteriosus (PDA) is common in premature infants.
- Indomethacin is frequently used to treat PDA.
- The effects of indomethacin on renal function in neonates require further elucidation.
Purpose of the Study:
- To investigate the impact of indomethacin on renal function in premature infants with PDA.
- To quantify changes in urinary flow, glomerular filtration rate (GFR), and electrolyte excretion during indomethacin therapy.
Main Methods:
- A cohort of 12 premature infants with PDA received indomethacin treatment.
- Renal function parameters, including urinary flow rate, GFR, and ion excretion (Na, Cl, K), were measured.
- Plasma sodium concentration and osmolality were also monitored.
Main Results:
- Indomethacin therapy led to significant reductions in urinary flow rate (56%), GFR (27%), and free water reabsorption (CH2O) (66%).
- Urinary excretion of sodium (70%), chloride (79%), and potassium (40%) decreased markedly.
- Slight decreases in plasma sodium and osmolality were observed.
Conclusions:
- Indomethacin significantly impairs renal function in premature infants with PDA.
- Most renal functions, except GFR and urinary sodium/osmolality, normalized within 1-2 weeks after drug cessation.
- Close monitoring of renal function is crucial during indomethacin treatment in neonates.
Abstract:
Renal function during indomethacin treatment was studied in 12 premature infants with patent ductus arteriosus. Decreases in urinary flow rate, GFR, and CH2O by 56, 27, and 66%, respectively, occurred during Indo therapy. Urinary excretion rates of ions were also reduced: Na by 70%, Cl by 79%, K by 40%. These changes were accompanied by slight decreases in plasma sodium concentration and osmolality. Except for GFR and urinary Na and osmolality, all these functions returned to pretreatment values one to two weeks after stopping the drug.