Differential renal adverse effects of ibuprofen and indomethacin in preterm infants: a review

Figures & data

Table 1 Urine output in preterm infants with patent ductus arteriosus following the administration of ibuprofen or indomethacin

Ibuprofen			Indomethacin			P-value	Reference
Urine output	Doses: Initial, after 24 h, after 48 h (mg/kg)	Number of infants	Urine output	Daily dose, for 3 days (mg/kg)	Number of infants
1.79±0.61a	10, 5, 5	52	1.44±0.74a	A	88	0.002	^Citation21
4.0±1.4b	10, 5, 5	185	3.6±1.4b	B	165	0.008	^Citation15
3.5±1.2b	10, 5, 5	94	2.8±1.2b	0.2	81	<0.05	^Citation20
3.6±1.3b	10, 5, 5	32	2.8±1.1b	0.2	31	<0.02	^Citation25

Notes: Urine output is the mean ± standard deviation.

a g/kg/h;

b mL/kg/h. A: Indomethacin was given in three doses at 24-hour intervals depending on patient age (<48 hours of life, the initial dose was 0.2 mg/kg, followed by 0.1 mg/kg × two doses every 24 hours. When the age was 2–7 days, the dose of indomethacin was 0.2 mg/kg three times a day. When the age was >7 days, the initial indomethacin dose was 0.2 mg/kg, followed by two doses of 0.25 mg/kg every 24 hours). B: When the body weight was <750 g, the initial indomethacin dose was 0.2 mg/kg, followed by two doses of 0.1 mg/kg every 24 hours. When the body weight was from 750 to 1,000 g, the indomethacin dose was 0.2 mg/kg daily for 3 days. When the body weight was >1,000 g, the dose of indomethacin was 0.2 mg/kg every 12 hours.

Abbreviation: h, hous.

Table 2 Serum creatinine concentrations in preterm infants treated with ibuprofen or indomethacin for the closure of the patent ductus arteriosus

Time after dosing	Ibuprofen			Indomethacin			P-value	Reference
	Creatinine concentration (mg/dL)	Doses: Initial, after 24 h, after 48 h (mg/kg)	Number of infants	Creatinine concentration (mg/dL)	Daily dose, for 3 days (mg/kg)	Number of infants
NA	0.98±0.24	10, 5, 5	185	1.06±0.24	A	165	0.005	^Citation15
24 hours	1.05±0.36	10, 5, 5	73	1.33±0.46	0.2	46	<0.001	^Citation22
2–7 days	1.11±0.39			1.53±0.5			<0.001
24 hours	1.30±0.35	10, 5, 5	32	1.71±0.62	0.2	31	<0.01	^Citation24
48 hours	1.48±0.27			2.03±2.10			<0.01
NA	81±20.0a	10, 5, 5	94	89±24.0a	0.2	81	<0.05	^Citation20

Notes: Creatinine concentrations are the mean ± standard deviation.

a μmol/L. A: When the body weight was <750 g, the initial indomethacin dose was 0.2 mg/kg, followed by two daily doses of 0.1 mg/kg. When the body weight was 750–1,000 g, the indomethacin dose was 0.2 mg/kg for 3 days. When the body weight was >1,000 g, the indomethacin dose was 0.2 mg/kg every 12 hours.

Abbreviation: NA, not available.

Table 3 Number of preterm infants with oliguria following the administration of ibuprofen or indomethacin for the closure of the patent ductus arteriosus

Ibuprofen			Indomethacin			P-value	Reference
Number of infants treated with ibuprofen	Number of infants with oliguria	Percentage of infants with oliguria	Number of infants treated with indomethacin	Number of infants with oliguria	Percentage of infants with oliguria
94	1	1.0	81	12	14.8	0.017	^Citation20
74	5	6.7	74	14	18.9	0.037	^Citation10
22	1	5.0	20	8	40.0	0.02	^Citation25a
52	5	9.6	88	33	37.5	0.002	^Citation21

Notes:

a Infants with a body weight <1,000 g. Indomethacin was given in three doses at 24-hour intervals depending on patient age (<48 hours of life, the initial dose was 0.2 mg/kg, followed by 0.1 mg/kg × two doses every 24 hours. When the age was 2–7 days, the dose of indomethacin was 0.2 mg/kg × three times daily. When the age was >7 days, the initial indomethacin dose was 0.2 mg/kg, followed by two doses of 0.25 mg/kg every 24 hours). Ibuprofen was administered at the dose of 10 mg/kg, followed by 5 mg/kg after 24 and 48 hours.

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