Abstract
The side effects of indomethacin for ductal closure in preterm neonates (e.g. increased incidence of necrotizing enterocolitis, decreased cerebral blood volume and transient renal failure) have led clinicians to seek a safer alternative. Intravenous indomethacin and ibuprofen appear to be equally effective for patent ductus arteriosus closure, but oral ibuprofen remains an experimental option with theoretical advantages yet with potential side effects. We herein report a case of transient but severe acute renal failure developing in a preterm infant in whom oral ibuprofen was used and discuss the safety of this drug in relation to its pharmacokinetics.
References
Shah SS, Ohlsson A (2006) Ibuprofen for the prevention of patent ductus arteriosus in preterm and/or low birth weight infants. Cochrane Database Syst Rev 1:CD004213
Giniger RP, Buffat C, Millet V, Simeoni U (2007) Renal effects of ibuprofen for the treatment of patent ductus arteriosus in premature infants. J Maternal Fetal Neonatal Med 20:275–283
Tiker F, Yildirim SF (2007) Acute renal impairment after oral ibuprofen for medical closure of patent ductus arteriosus. Indian Pediatr 44:54–55
Heyman E, Morag I, Batash D, Keidar R, Barm S, Berkovitch M (2003) Closure of patent ductus arteriosus with oral ibuprofen suspension in premature newborns: a pilot study. Pediatrics 112:354–358
Ohlsson A, Walia R, Shah S (2005) Ibuprofen for the treatment of patent ductus arterious in preterm and/or low birth weight. Cochrane Database Syst Rev 4:CD003481
Hariprasad P, Sundarrajan V, Srimathy G, Suthagar B, Ramadevi BS (2002) Oral ibuprofen for closure of hemodynamically significant PDA in premature neonates. Indian Pediatr 39:99–100
Chotigeat U, Jirapapa K, Layangkool T (2003) A comparison of oral ibuprofen and intravenous indomethacin for closure of patent ductus arteriosus in preterm infants. J Med Assoc Thai 86:S563–569
Tatli MM, Kumral A, Duman N, Demir K, Gurcu O, Ozkan H (2004) Spontaneous intestinal perforation after oral ibuprofen treatment of patent ductus arteriosus in two very-low-birthweight infants. Acta Paediatr 93:999–1001
Simeoni U, Matis J, Messer J (1996) Clinical implications of renal immaturity in tiny, premature infants. In: Cataldi L, Fanos V, Simeoni U (eds) Neonatal nephrology in progress. Agora, Lecce, pp 129–140
Van Overmeire B, Touw D, Schepens P, Kearns GL, van den Anker JN (2001) Ibuprofen in preterm infants with patent ductus arteriosus. Clin Pharmacol Ther 70:336–343
Sharma PK, Garg SK, Narang A (2003) Pharmacokinetics of oral ibuprofen in premature infants. J Clin Pharmacol 43:968–973
Akima S, Kent A, Reynolds GJ, Gallagher M, Falk MC (2004) Indomethacin and renal impairment in neonates. Pediatr Nephrol 19:490–493
Thomas RL, Parker KC, Van Overmeire B, Aranda JV (2005) A meta-analysis of ibuprofen versus indomethacin for closure of patent ductus arteriosus. Eur J Pediatr 164:135–140
Murray MD, Brater DC (1997) Effects of NSAIDs on the kidney. Prog Drug Res 49:155–171
Moghal NE, Hegde S, Eastham KM (2004) Ibuprofen and acute renal failure in a toddler. Arch Dis Child 89:276–277
Lesko SM, Mitchell AA (1999) The safety of and ibuprofen among children younger than two years old. Pediatrics 104:e39
Kelly MT, Walson PD, Edge JH, Cox S, Mortensen ME (1992) Pharmacokinetics and pharmacodynamics of ibuprofen isomers and acetaminophen in febrile children. Clin Pharmacol Ther 52:181–189
Aranda JV, Thomas R (2006) Systemic review: i.v. ibuprofen in preterm infants. Semin Perinatol 30:114–120
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Erdeve, O., Sarici, S.U., Sari, E. et al. Oral-ibuprofen-induced acute renal failure in a preterm infant. Pediatr Nephrol 23, 1565–1567 (2008). https://doi.org/10.1007/s00467-008-0835-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-008-0835-9