Acute renal impairment after oral ibuprofen for medical closure of patent ductus arteriosus.

INDIAN PEDIATRICS 54 VOLUME 44JANUARY 17, 2007 Patent ductus arteriosus (PDA) is a common occurance in preterm infants with significant morbidities. Indomethacin, has been widely used to treat hemodynamically significant PDA. However, this agent can cause adverse reactions such as reduced renal, mesenteric, and cerebral perfusion leading to transient or permanent renal dysfunction, necrotizing enterocolitis, gastrointestinal hemorrhage, and intraventricular hemorrhage or periventricular leukomalacia(1). Research has shown that ibuprofen is as effective as indomethacin for achieving PDA closure with minimal adverse effects(2-3). However, before giving treatment an accurate echocardiography should rule out ductus dependent cardiac malformations, because ibuprofen/indomethacin can be dangerous and highly fatal in these conditions. This paper reports a preterm infant who was treated with oral ibuprofen and developed acute transient renal failure.