Effect of ibuprofen for hemodynamically significant patent ductus arteriosus closure on the development of acute kidney injury in preterm infants
Open Access
- 26 March 2021
- journal article
- research article
- Published by Dnipro State Medical University in Medicni perspektivi
- Vol. 26 (1), 156-162
- https://doi.org/10.26641/2307-0404.2021.1.227960
Abstract
Premature infants with hemodynamically significant patent ductus arteriosus (HSPDA) have a high risk of developing acute kidney injury (AKI) due to renal hypoperfusion and use of ibuprofen for duct closure. The aim of the study was to evaluate the effect of ibuprofen for the closure of HSPDA on the development of AKI in preterm infants depending on high dose of the drug on the first day of life. 40 preterm infants with HSPDA who were admitted for observation on the first day of life were examined. To close the ductus arteriosus, infants received restrictive therapy. In addition, 32 (80,0%) preterm infants on the first day of life were prescribed ibuprofen: 19 infants – in high dose (20 mg/kg), 13 infants – in standard dose (10 mg/kg). Clinical examination and treatment of preterm infants was carried out according to the generally accepted methods. Echocardiography with Doppler was performed at 5-11 hours of life and then daily to determine the size and hemodynamic significance of patent ductus arteriosus. Diagnosis and stratification of the severity of AKI were performed according to the criteria of neonatal modification of KDIGO, for which the concentration of serum creatinine and diuresis were studied. According to the results of the study, it was established that the frequency of AKI on the third and fifth days of life in preterm infants with HSPDA, who received ibuprofen in a high dose (20 mg/kg) on the first day, was 73.7% and 84.2%, respectively, which is 2.2 (OR=5.6; CI: 1,43-21,95; р<0.02) and 2.5 (OR=10.67; CI: 2.31-49.31; р<0.002) times, more often than in infants without such therapy. High dose of ibuprofen on the first day of life in preterm infants with HSPDA are most often associated with the development of stage I AKI on the third or fifth day of life, which was temporary in one third of patients. The use of a high-dose ibuprofen for HSPDA closure on the first day of life in preterm infants was significantly more often associated with foci of infection in the mother, large duct size and furosemide use.Keywords
This publication has 13 references indexed in Scilit:
- Management of patent ductus arteriosus in premature infants.Medicni perspektivi, 2019
- Patent ductus arteriosus is associated with acute kidney injury in the preterm infantPediatric Nephrology, 2019
- What is a hemodynamically significant PDA in preterm infants?Congenital Heart Disease, 2018
- Extending the Case–Control Design to Longitudinal DataEpidemiology, 2018
- Efficacy and safety of rectal ibuprofen for patent ductus arteriosus closure in very low birth weight preterm infantsThe Journal of Maternal-Fetal & Neonatal Medicine, 2017
- Renal consequences of preterm birthMolecular and Cellular Pediatrics, 2017
- The spectrum of onset of acute kidney injury in premature infants less than 30 weeks gestationJournal of Perinatology, 2016
- Neonatal Acute Kidney InjuryPEDIATRICS, 2015
- Drug-Induced Renal Damage in Preterm Neonates: State of the Art and Methods for Early DetectionDrug Safety, 2015
- High-Dose Ibuprofen for Patent Ductus Arteriosus in Extremely Preterm Infants: A Randomized Controlled StudyClinical Pharmacology & Therapeutics, 2011