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Methylxanthines increase renal calcium excretion in preterm infants
V Zanardo1, C Dani, D Trevisanuto
1Department of Pediatrics, University of Padova School of Medicine, Italy.
Biology of the Neonate
|January 1, 1995
Summary
Methylxanthine treatments like theophylline and caffeine increased urinary calcium excretion in premature infants. Further research is needed to assess long-term renal effects and risks like nephrocalcinosis.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Nephrology
Background:
- Premature neonates often receive methylxanthines for respiratory issues.
- The renal effects of these treatments, particularly on calcium excretion, require thorough investigation.
Purpose of the Study:
- To evaluate the impact of theophylline and caffeine on renal function and urinary calcium in premature neonates.
- To compare the effects of these two methylxanthines on renal parameters.
Main Methods:
- 20 premature neonates with apnea or RDS were randomized to theophylline or caffeine.
- A 24-hour pretreatment period was followed by a 24-hour post-treatment period after 5 days of methylxanthine administration.
- Serum and urine electrolytes, creatinine, and creatinine clearance were measured.
Main Results:
- Serum creatinine significantly decreased post-treatment.
- Urinary calcium excretion, Ca/creatinine, and Ca/Na ratios significantly increased.
- Theophylline showed a more pronounced increase in calciuria compared to caffeine.
- Renal function markers like creatinine clearance and fractional sodium excretion remained stable.
Conclusions:
- Short-term methylxanthine therapy in premature neonates significantly increases urinary calcium excretion.
- Theophylline appears to have a greater effect on calciuria than caffeine.
- Long-term renal effects, including risks of nephrocalcinosis and osteopenia, warrant further investigation, especially with concurrent diuretic use.