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A randomised, double-blind, placebo-controlled trial of the effect of theophylline in prevention of vasomotor nephropathy in very preterm neonates with respiratory distress syndrome.

Author(s): Cattarelli D, Spandrio M, Gasparoni A, Bottino R, Offer C, Chirico G

Affiliation(s): Spedali Civili, Italy.

Publication date & source: 2005-10-04, Arch Dis Child Fetal Neonatal Ed., [Epub ahead of print]

BACKGROUND: Vasomotor nephropathy is a frequently observed renal dysfunction in very preterm neonates. OBJECTIVE: To determine whether theophylline could prevent vasomotor nephropathy in very preterm infants with respiratory distress syndrome (RDS). METHODS: Randomized double-blind, placebo- controlled trial of 50 preterm infants with gestational age </=32 weeks needing assisted ventilation. Infants received an intravenous dose of theophylline (1 mg/Kg) or placebo for three days. Twenty-four-hours urine volume was measured daily. On day 2, 5 and 11, blood samples and 12-hours urine collection were analysed for electrolytes, creatinine, urea. RESULTS: On day 1 urine output was significantly higher in theophylline (2.4+/-0.9 ml/Kg/h) than in placebo group (1.6+/-1.0 ml/Kg/h; p=0.023); the incidence of oligoanuria was significantly lower in treated (4.7%) than in placebo group (33%). Twenty-four hours after the first administration of theophylline/placebo, serum creatinine was significantly lower in theophylline (0.76+/-0.23 mg/dl) than in placebo group (1.0+/-0.41 mg/dl; p=0.025). On day 5 an increase of serum creatinine was observed in both groups. On day 11 a significant reduction of serum creatinine was observed, as compared to day 5, without difference between the two groups. CONCLUSIONS: Our results suggest that in very preterm infants with RDS early theophylline administration improves renal function during the two first days of life.

Page last updated: 2006-01-31

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