Randomized Trial to Compare Renal Function and Ductal Response between Indomethacin and Ibuprofen Treatment in Extremely Low Birth Weight Infants

Yuh Jyh Lin, Chung Ming Chen, Virender K. Rehan, Adrian Florens, Shou Yien Wu, Min Luen Tsai, Yung T. Kuo, Fu Kuei Huang, Tsu F. Yeh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: A head to head comparison study on renal function and ductal response between indomethacin and ibuprofen has rarely been conducted in extremely low birth weight (ELBW) infants. Objectives: The aim was to compare renal function and ductal response between indomethacin and ibuprofen in ELBW infants. Methods: We performed a double-blind randomized control trial to compare renal function and ductal response between indomethacin (0.2, 0.1, and 0.1 mg/kg i.v. every 24 h for 3 doses) and ibuprofen lysine (10, 5, and 5 mg/kg i.v. every 24 h for 3 doses) in ELBW infants with significant hemodynamic patent ductus arteriosus (cardiovascular dysfunction score >3 and LA/AO ratio ≥1.3). Results: A total of 144 infants were enrolled: 73 received indomethacin and 71 received ibuprofen lysine. Significant decreases in urine output were seen in 30 infants (41%) in the indomethacin group and 15 (21%) in the ibuprofen group (p = 0.02). The indomethacin group was associated with a significantly higher chance of persistent ductal response than the ibuprofen group (66 vs. 49%, p = 0.046), but with a lower glomerular filtration rate on day 1, higher serum creatinine on days 1, 2, and 7, and lower urinary prostaglandin on days 2-7. Both groups were comparable in mortality and in bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity morbidity. Conclusions: With the current dosage, ibuprofen had fewer renal side effects but was associated with a lower rate of persistent ductal closure in ELBW infants. The precise role of prostaglandin on renal tubular function in ELBW infants remains to be further investigated.

Original languageEnglish
Pages (from-to)195-202
Number of pages8
JournalNeonatology
Volume111
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Fingerprint

Extremely Low Birth Weight Infant
Ibuprofen
Indomethacin
Kidney
Prostaglandins
Therapeutics
Bronchopulmonary Dysplasia
Retinopathy of Prematurity
Necrotizing Enterocolitis
Patent Ductus Arteriosus
Glomerular Filtration Rate
Creatinine
Hemodynamics
Urine
Hemorrhage
Morbidity
Mortality
Serum

Keywords

  • Extremely low birth weight infants
  • Ibuprofen
  • Indomethacin
  • Patent ductus arteriosus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Biology

Cite this

Randomized Trial to Compare Renal Function and Ductal Response between Indomethacin and Ibuprofen Treatment in Extremely Low Birth Weight Infants. / Lin, Yuh Jyh; Chen, Chung Ming; Rehan, Virender K.; Florens, Adrian; Wu, Shou Yien; Tsai, Min Luen; Kuo, Yung T.; Huang, Fu Kuei; Yeh, Tsu F.

In: Neonatology, Vol. 111, No. 3, 01.03.2017, p. 195-202.

Research output: Contribution to journalArticle

Lin, Yuh Jyh ; Chen, Chung Ming ; Rehan, Virender K. ; Florens, Adrian ; Wu, Shou Yien ; Tsai, Min Luen ; Kuo, Yung T. ; Huang, Fu Kuei ; Yeh, Tsu F. / Randomized Trial to Compare Renal Function and Ductal Response between Indomethacin and Ibuprofen Treatment in Extremely Low Birth Weight Infants. In: Neonatology. 2017 ; Vol. 111, No. 3. pp. 195-202.
@article{f95fb133a852425c81fd0e8b6e32d84f,
title = "Randomized Trial to Compare Renal Function and Ductal Response between Indomethacin and Ibuprofen Treatment in Extremely Low Birth Weight Infants",
abstract = "Background: A head to head comparison study on renal function and ductal response between indomethacin and ibuprofen has rarely been conducted in extremely low birth weight (ELBW) infants. Objectives: The aim was to compare renal function and ductal response between indomethacin and ibuprofen in ELBW infants. Methods: We performed a double-blind randomized control trial to compare renal function and ductal response between indomethacin (0.2, 0.1, and 0.1 mg/kg i.v. every 24 h for 3 doses) and ibuprofen lysine (10, 5, and 5 mg/kg i.v. every 24 h for 3 doses) in ELBW infants with significant hemodynamic patent ductus arteriosus (cardiovascular dysfunction score >3 and LA/AO ratio ≥1.3). Results: A total of 144 infants were enrolled: 73 received indomethacin and 71 received ibuprofen lysine. Significant decreases in urine output were seen in 30 infants (41{\%}) in the indomethacin group and 15 (21{\%}) in the ibuprofen group (p = 0.02). The indomethacin group was associated with a significantly higher chance of persistent ductal response than the ibuprofen group (66 vs. 49{\%}, p = 0.046), but with a lower glomerular filtration rate on day 1, higher serum creatinine on days 1, 2, and 7, and lower urinary prostaglandin on days 2-7. Both groups were comparable in mortality and in bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity morbidity. Conclusions: With the current dosage, ibuprofen had fewer renal side effects but was associated with a lower rate of persistent ductal closure in ELBW infants. The precise role of prostaglandin on renal tubular function in ELBW infants remains to be further investigated.",
keywords = "Extremely low birth weight infants, Ibuprofen, Indomethacin, Patent ductus arteriosus",
author = "Lin, {Yuh Jyh} and Chen, {Chung Ming} and Rehan, {Virender K.} and Adrian Florens and Wu, {Shou Yien} and Tsai, {Min Luen} and Kuo, {Yung T.} and Huang, {Fu Kuei} and Yeh, {Tsu F.}",
year = "2017",
month = "3",
day = "1",
doi = "10.1159/000450822",
language = "English",
volume = "111",
pages = "195--202",
journal = "Neonatology",
issn = "1661-7800",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - Randomized Trial to Compare Renal Function and Ductal Response between Indomethacin and Ibuprofen Treatment in Extremely Low Birth Weight Infants

AU - Lin, Yuh Jyh

AU - Chen, Chung Ming

AU - Rehan, Virender K.

AU - Florens, Adrian

AU - Wu, Shou Yien

AU - Tsai, Min Luen

AU - Kuo, Yung T.

AU - Huang, Fu Kuei

AU - Yeh, Tsu F.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background: A head to head comparison study on renal function and ductal response between indomethacin and ibuprofen has rarely been conducted in extremely low birth weight (ELBW) infants. Objectives: The aim was to compare renal function and ductal response between indomethacin and ibuprofen in ELBW infants. Methods: We performed a double-blind randomized control trial to compare renal function and ductal response between indomethacin (0.2, 0.1, and 0.1 mg/kg i.v. every 24 h for 3 doses) and ibuprofen lysine (10, 5, and 5 mg/kg i.v. every 24 h for 3 doses) in ELBW infants with significant hemodynamic patent ductus arteriosus (cardiovascular dysfunction score >3 and LA/AO ratio ≥1.3). Results: A total of 144 infants were enrolled: 73 received indomethacin and 71 received ibuprofen lysine. Significant decreases in urine output were seen in 30 infants (41%) in the indomethacin group and 15 (21%) in the ibuprofen group (p = 0.02). The indomethacin group was associated with a significantly higher chance of persistent ductal response than the ibuprofen group (66 vs. 49%, p = 0.046), but with a lower glomerular filtration rate on day 1, higher serum creatinine on days 1, 2, and 7, and lower urinary prostaglandin on days 2-7. Both groups were comparable in mortality and in bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity morbidity. Conclusions: With the current dosage, ibuprofen had fewer renal side effects but was associated with a lower rate of persistent ductal closure in ELBW infants. The precise role of prostaglandin on renal tubular function in ELBW infants remains to be further investigated.

AB - Background: A head to head comparison study on renal function and ductal response between indomethacin and ibuprofen has rarely been conducted in extremely low birth weight (ELBW) infants. Objectives: The aim was to compare renal function and ductal response between indomethacin and ibuprofen in ELBW infants. Methods: We performed a double-blind randomized control trial to compare renal function and ductal response between indomethacin (0.2, 0.1, and 0.1 mg/kg i.v. every 24 h for 3 doses) and ibuprofen lysine (10, 5, and 5 mg/kg i.v. every 24 h for 3 doses) in ELBW infants with significant hemodynamic patent ductus arteriosus (cardiovascular dysfunction score >3 and LA/AO ratio ≥1.3). Results: A total of 144 infants were enrolled: 73 received indomethacin and 71 received ibuprofen lysine. Significant decreases in urine output were seen in 30 infants (41%) in the indomethacin group and 15 (21%) in the ibuprofen group (p = 0.02). The indomethacin group was associated with a significantly higher chance of persistent ductal response than the ibuprofen group (66 vs. 49%, p = 0.046), but with a lower glomerular filtration rate on day 1, higher serum creatinine on days 1, 2, and 7, and lower urinary prostaglandin on days 2-7. Both groups were comparable in mortality and in bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity morbidity. Conclusions: With the current dosage, ibuprofen had fewer renal side effects but was associated with a lower rate of persistent ductal closure in ELBW infants. The precise role of prostaglandin on renal tubular function in ELBW infants remains to be further investigated.

KW - Extremely low birth weight infants

KW - Ibuprofen

KW - Indomethacin

KW - Patent ductus arteriosus

UR - http://www.scopus.com/inward/record.url?scp=84995769245&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995769245&partnerID=8YFLogxK

U2 - 10.1159/000450822

DO - 10.1159/000450822

M3 - Article

C2 - 27842315

AN - SCOPUS:84995769245

VL - 111

SP - 195

EP - 202

JO - Neonatology

JF - Neonatology

SN - 1661-7800

IS - 3

ER -