[Effect of dexamethasone and spironolactone therapy in calcium and phosphate homeostasis in premature infants with a birth weight under 1,500 g].
BACKGROUND
Dexamethasone and spironolactone are widely used in the management of bronchopulmonary dysplasia in premature infants. There are few data available about adverse effects of this drugs on the urinary excretion of calcium and phosphate in this group of patients.


METHODS
24 h-urine samples could be collected in 85 infants between 8 and 40 days. 31 infants received dexamethasone and 32 spironolactone.


METHODS
Multivariate variance analysis was performed to study the influence of dexamethasone and spironolactone on the measured excretion of calcium and phosphate. The influence of gestational and postnatal age, calcium and phosphate intake and theophylline treatment were excluded by use as covariates.


RESULTS
Spironolactone showed no significant influence on the urinary excretion of calcium or phosphate. Dexamethasone treatment increased the daily excretion of phosphate in the urine and decreased the phosphate concentration in serum.


CONCLUSIONS
None of the examined drugs showed a significant increase of the renal excretion of calcium in preterm infants. Thus a higher risk of nephrocalcinosis development due to these drugs has not been confirmed. Dexamethasone treatment might increase the risk of osteopenia by enhancing phosphate excretion.
Virchow-Klinikum, Humboldt Universität Berlin.
J
J
Sonntag
M
M
Gaude
D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy* / Q000652:urine; D002118:Calcium / Q000652:urine*; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D009397:Nephrocalcinosis / Q000139:chemically induced / Q000652:urine; D010710:Phosphates / Q000652:urine*; D012307:Risk Factors; D013148:Spironolactone / Q000008:administration & dosage / Q000009:adverse effects*; D014882:Water-Electrolyte Balance / Q000187:drug effects
D010710:Phosphates; D013148:Spironolactone; D003907:Dexamethasone; D002118:Calcium
Einfluss einer Dexamethason- und Spironolactontherapie auf den Kalzium- und Phosphathaushalt bei Frühgeborenen mit einem Geburtsgewicht unter 1500 g.