Theophylline for renal function in term neonates with perinatal asphyxia: a randomized, placebo-controlled trial.
OBJECTIVE
To study whether prophylactic theophylline can reduce the incidence and/or severity of renal failure in term infants with perinatal asphyxia.


METHODS
Term neonates with severe perinatal asphyxia were randomized to receive a single dose of either theophylline (study group, n = 40) or placebo (control group, n = 30) during the first hour of life. Daily weight, output/input ratio, 24-hour fluid intake, and urine volumes were recorded during the first 5 days of life. Those infants with asphyxial renal failure were followed up for 1 year.


RESULTS
The incidence of severe renal dysfunction was increased in the control group. Creatinine clearance was higher and excretion of beta 2 microglobulin (beta2M) was lower in the theophylline group. Conversely, the glomerular filtration rate was lower in the control group. In infants with renal failure, serum creatinine and creatinine clearance returned to normal in the neonatal period, and the increased beta2M excretion normalized by age 6 weeks.


CONCLUSIONS
A single dose of theophylline within the first hour of birth in term neonates with perinatal asphyxia results in a significant decrease in serum creatinine level and urinary excretion of beta2M, along with an increase in creatinine clearance.
Bhat
Mushtaq A
MA
Department of Pediatrics, Shere-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, Kashmir, India. mbhat47@rediffmail.com
Shah
Zaffar A
ZA
Makhdoomi
Mudasir S
MS
Mufti
Masood H
MH
D001238:Asphyxia Neonatorum / Q000188:drug therapy* / Q000453:epidemiology*; D001835:Body Weight; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control*; D012720:Severity of Illness Index; D013806:Theophylline / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D001613:beta 2-Microglobulin / Q000652:urine
D014665:Vasodilator Agents; D001613:beta 2-Microglobulin; D003404:Creatinine; D013806:Theophylline