EFFECTS OF PROLONGED INDOMETHACIN TREATME NT IN PRETERM INFANTS

Background. - Indomethacin therapy for large patent ductus arterious w ould be more effective when it is prescribed for 5 or 6 days vs 2 or 3 days. Effects on renal functian of such prolonged therapy is still de bated. Patients and methods. - Seven preterm infants (gestational age: 28.6 +/- 0.9 weeks; birthweight: 1169 +/- 267 g) with symptomatic pat ent ductus arterious were given indomethacin, 0.1 mg/kg/day for 6 days (four patients) and 5 days (three patients). Urinary wafer excretion, water output/input ratio, creatinine clearance and body weight were m easured before and every day during therapy. Results. - Urinary water excretion, water output/input ratio and creatinine clearance were sign ificantly decreased after 5 days of treatment - 40 +/- 30%, - 42 +/- 2 7% and - 48 +/- 31%, respectively. Creatininemia and body weight were significantly increased + 34 +/- 36% and + 9 +/- 7%, respectively. Mea n sodium plasma level and fractional excretion of sodium, potassium an d chloride remained stable. Conclusion. - Prolonged therapy with indom ethacin does not avoid the renal side effects seen with shorter admini stration.