Furosemide in preterm infants treated with indomethacin for patent ductus arteriosus.
OBJECTIVE
To evaluate the effect of furosemide on renal function and water balance in preterm infants treated with indomethacin (3 x 0.2 mg/kg at 12-h intervals) for symptomatic patent ductus arteriosus.


METHODS
We performed a retrospective multi-centre double cohort study in preterm infants <32 weeks of gestational age. Thirty-two infants treated with furosemide (1 mg/kg i.v.) before each indomethacin dose (furosemide group) were matched with 32 infants with indomethacin treatment alone (control-group). Renal effects (urine output, weight gain, serum creatinine, sodium concentration) were registered.


RESULTS
The study groups were comparable for gestational age, birth weight and day of therapy. Pretreatment differences were observed for urine output, weight and serum sodium. However, no differences were noticed in day-to-day urine output change or weight gain between the groups. A significant increase in serum creatinine concentration (50% vs. control, 18%; p < 0.05) and a concomitant significant decrease in serum sodium (-9 vs. control, -3 mmoL/L; p < 0.05) in the furosemide group was observed 72-96 h after starting therapy.


CONCLUSIONS
Furosemide before each indomethacin dose resulted in a significant increase in serum creatinine and hyponatremia, without increasing urine output.
Andriessen
Peter
P
Department of Neonatology, Máxima Medical Centre, Veldhoven, The Netherlands. p.andriessen@mmc.nl
Struis
Nicole C
NC
Niemarkt
Hendrik
H
Oetomo
Sidarto Bambang
SB
Tanke
Ronald B
RB
Van Overmeire
Bart
B
D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects; D004232:Diuretics / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use*; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects*; D007231:Infant, Newborn; D007234:Infant, Premature; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D007677:Kidney Function Tests; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D016896:Treatment Outcome; D014556:Urine
D016861:Cyclooxygenase Inhibitors; D004232:Diuretics; D005665:Furosemide; D012964:Sodium; D003404:Creatinine; D007213:Indomethacin