Effects of ibuprofen and indomethacin on urinary antidiuretic hormone excretion in preterm infants treated for patent ductus arteriosus.
OBJECTIVE
To compare the effects of intravenous ibuprofen and indomethacin for treatment of patent ductus arteriosus (PDA) on urinary antidiuretic hormone (ADH) excretion, as a cause of oliguria.


METHODS
Forty-four respiratory distress syndrome prematures (<or=34 weeks' gestation) with PDA received either ibuprofen (n = 22) in an initial dose of 10 mg/kg followed by two doses of 5 mg/kg each after 24 and 48 h or three doses at 12-hour intervals of indomethacin (n = 24), 0.2 mg/kg, both infused continuously over a period of 15 min. Urinary ADH excretion, diuresis, serum creatinine, urinary sodium, fractional excretion of sodium, and urinary osmolality were measured before and after treatment.


RESULTS
Indomethacin treatment caused a significant decrease in urinary ADH excretion (21.8 +/- 20.8 vs. 13.8 +/- 12.9 pg/ml; p < 0.05), along with a significant reduction in urinary sodium (92.1 +/- 36.1 vs. 64.8 +/- 35.6; p < 0.05), fractional excretion of sodium (68.5 +/- 37.1 vs. 45.6 +/- 37.1; p < 0.05), and urinary osmolality (276.2 +/- 103.9 vs. 226.4 +/- 60.3; p < 0.05). Ibuprofen treatment did not modify urinary ADH excretion and caused a statistically insignificant decrease in urinary sodium and in fractional excretion of sodium.


CONCLUSIONS
Compared with ibuprofen, indomethacin caused a significant reduction in urinary ADH excretion and a significant decrease in urinary sodium and osmolality.
Zanardo
Vincenzo
V
Pediatrics Department, Padua University School of Medicine, Padua, Italy. zanardo@pediatria.unipd.it
Vedovato
Stefania
S
Lago
Paola
P
Piva
Daniele
D
Faggian
Diego
D
Chiozza
Laura
L
D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects* / Q000494:pharmacology; D007213:Indomethacin / Q000009:adverse effects* / Q000494:pharmacology; D007231:Infant, Newborn; D007234:Infant, Premature; D009846:Oliguria / Q000139:chemically induced*; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology; D014667:Vasopressins / Q000378:metabolism* / Q000652:urine
D016861:Cyclooxygenase Inhibitors; D014667:Vasopressins; D007052:Ibuprofen; D007213:Indomethacin