Abstract
The aim of this investigation was to evaluate whether the relative change in renal clearance due to ibuprofen administration depends on the gestational age (GA). Clearance of amikacin was used as a surrogate marker for renal clearance in preterm infants (GA 24–34 weeks, day 1) on respiratory support. Clearance in infants co-treated with ibuprofen was compared to that of infants not co-treated with ibuprofen. Absolute change of clearance in four consecutive cohorts of increasing (<27, 27–28, 29–31, 32–34 weeks) GA and linear correlations of clearance on GA were calculated in both groups. Data were collected from 204 infants, of whom 93 were co-treated with ibuprofen. Mean amikacin clearance was lower (0.48 to 0.59 ml/kg/min, P <0.001) in infants co-treated with ibuprofen. Absolute decrease in mean amikacin clearance (0.10 to 0.14 ml/kg/min) was similar in all four cohorts. Linear correlations of clearance with GA were documented in infants co-treated (y =0.21+0.011x) or not co-treated (y =0.44+0.009x) with ibuprofen. Renal clearance, reflected by amikacin clearance, is decreased by ibuprofen in preterm infants of 24 to 34 weeks GA on respiratory support on the 1st day of life, independent of the GA.
Similar content being viewed by others
References
Van Overmeire B, Smets K, Lecoutere D, Van de Broek H, Weyler J, Degroote K, Langhendries JP (2000) A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. N Engl J Med 343: 674–681
Lago P, Bettiol T, Salvadori S, Pitassi I, Vianello A, Chiandetti L, Saia OS (2002) Safety and efficacy of ibuprofen versus indomethacin in preterm infants treated for patent ductus arteriosus: a randomised controlled trial. Eur J Pediatr 161: 202–207
Guignard JP (2002) The adverse renal effects of prostaglandin-synthesis inhibitors in the newborn rabbit. Semin Perinatol 26: 398–405
Van den Anker JN (1996) Pharmacokinetics and renal function in preterm infants. Acta Paediatr 85: 1393–1399
Koren G, James A, Perlman M (1985) A simple method for the estimation of glomerular filtration rate by gentamicin pharmacokinetics during routine drug monitoring in the newborn. Clin Pharamcol Ther 38: 680–685
Satas S, Hoem NO, Melby K, Porter H, Lindgren CG, Whitelaw A, Thoresen M (2000) Influence of mild hypothermia after hypoxia-ischemia on the pharmacokinetics of gentamicin in newborn pigs. Biol Neonate 77: 50–57
Allegaert K, Cossey V, Langhendries JP, Naulaers G, Vanhole C, Devlieger H, Van Overmeire B (2004) Effect of ibuprofen-lysine on pharmacokinetics of amikacin in preterm infants in the first day of life. Biol Neonate 86: 207–211
Van Overmeire B, Allegaert K, Casaer A, Debauche C, Decaluwé W, Jespers A, Weyler J, Harrewijn I, Langhendries JP and the Multicenter Ibuprofen Prophylaxis Group (2004) The prophylactic administration of ibuprofen in preterm infants. Lancet 364: 1945–1949
Langhendries JP, Battisti O, Bertrand JM, Francois A, Kalenga M, Darimont J, Scalais E, Wallemacq P (1998) Adaptation in neonatology of the one-daily concept of aminoglycoside administration: evaluation of a dosing chart for amikacin in an intensive care unit. Biol Neonate 74: 351–362
Van den Anker JN, de Groot R, Broerse HM, Sauer PJ, van der Heijden BJ, Hop WC, Lindemans J (1995) Assessment of glomerular filtration rate in preterm infants by serum creatinine: comparison with inulin clearance. Pediatrics 96: 1156–1158
Chamaa NS, Mosig D, Drukker A, Guignard JP (2000) The renal hemodynamic effects of ibuprofen in the newborn rabbit. Pediatr Res 48: 600–605
Hartmann SE, Langhendries JP, Debauche C, Bernard A, Van Overmeire B (2002) The influence of ibuprofen on renal tubular function in extremely low birth weight infants, a multicenter placebo-controlled evaluation. Pediatr Res 51: 338A
Schmidt B, Davis P, Moddemann D, Ohlsson A, Roberts RS, Saigal S, Solimano A, Vincer M, Wright LL (2001) Long-term effects of indomethacin prophylaxis in extremely-low-birth-weight infants. N Engl J Med 344: 1966–1972
Ment LR, Oh W, Ehrenkranz RA, Philip AG, Vohr B, Allan W, Duncan CC, Scott DT, Taylor KJ, Katz KH, Schneider KC, Makuch RW (1994) Low-dose indomethacin and prevention of intraventricular hemorrhage: a multicenter randomized trial. Pediatrics 93: 543–550
Acknowledgements
We thank Dr J. P Guignard, Department of Paediatrics, University Medical Centre, Lausanne, Switserland for his valuable suggestion to use this model for in vivo assessment of renal clearance. The clinical research of Karel Allegaert is supported by the Fund for Scientific Research, Flanders (Belgium) (F.W.O. Vlaanderen) by a Clinical Doctoral Grant (A 6/5–KV–G 1).
Author information
Authors and Affiliations
Corresponding author
Additional information
This work was presented at the meeting of the Dutch Society for Clinical Pharmacology and Biopharmacy, Lunteren, October 2004.
Rights and permissions
About this article
Cite this article
Allegaert, K., Cossey, V., Debeer, A. et al. The impact of ibuprofen on renal clearance in preterm infants is independent of the gestational age. Pediatr Nephrol 20, 740–743 (2005). https://doi.org/10.1007/s00467-005-1842-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-005-1842-8