NSAID-induced nephrotoxicity from the fetus to the child

In this review we report data available from the literature on the use of n onsteroidal anti-inflammatory drugs (NSAIDs) and the development of nephrot oxicity in the fetus, neonates and children. Up to the present day, several cases of severe and sometimes irreversible renal insufficiency have been d escribed in neonates exposed to indomethacin prenatally or in the first day s of life for treatment of patent ductus arteriosus (PDA). Until now, very few studies have been carried out on alternative treatments for PDA in pret erm infants; ibuprofen has been shown to be as effective as indomethacin in closing the ductus in this patient group without affecting renal function. In children. NSAID-induced renal failure is a rare event and is usually re versible after discontinuation of the drug. However, caution should be take n when NSAIDs are administered to individuals with preexisting renal proble ms or with other potentially nephrotoxic drugs. In these situations, new ap proaches such as cyclo-oxygenase-2 selective inhibitors or prostanoid recep tor selective antagonists could lead to alternative therapies for use in pa ediatrics.