Renal impairment associated with indomethacin treatment for patent ductus arteriosus in extremely preterm neonates—is postnatal age at start of treatment important?

Abstract

Objective. To study serum creatinine (SCr) levels following indomethacin for patent ductus arteriosus (PDA) closure in extremely preterm neonates in relation to postnatal age at the start of treatment. Methods. This was a retrospective (January 2000–December 2002) analysis of data on preterm neonates (gestation Results. Indomethacin was commenced at postnatal age p = 0.001) and peak SCr levels (0.099 (0.089,0.109) vs. 0.090 (0.064, 0.104) mmol/L, p = 0.015). Logistic regression analysis controlling for gestational age and baseline SCr level indicated that postnatal age ≥7 days was a risk factor for elevated SCr after indomethacin (OR = 13.4, 95% CI: 3.8–46.6, p < 0.001). Conclusion. Postnatal age ≥7 days at the start of indomethacin is a predictor of a significant rise in SCr in extremely preterm neonates.