Changes in urinary PGE2 after ibuprofen treatment in preterm infants with patent ductus arteriosus

PURPOSE: To investigate changes in urinary PGE(2) after ibuprofen treatment in preterm infants with patent ductus arteriosus (PDA). METHODS: Twenty preterm infants with a hemodynamically significant PDA (gestational age, 28.6 +/- 2.3 weeks) and 20 controls (gestational age, 30.4 +/- 1.5 weeks) were prospectively enrolled at 48-72 h of life. After enrollment, the former underwent conventional ibuprofen-lysine treatment. At 48-72 h (T(0)) and 108-144 h of life (T(1)), urine samples were noninvasively collected in both groups to measure urinary PGE(2) concentrations (enzyme immunoassay method), and renal function was investigated. RESULTS: Urinary PGE(2) decreased significantly both in ibuprofen-treated patients (66.95 +/- 16.78 vs. 27.15 +/- 17.92 pg/mL, P < 0.001) and in controls (71.7 +/- 16.2 vs. 53.2 +/- 18.4 pg/mL, P < 0.001) from T(0) to T(1). However, urinary PGE(2) at T(1) was significantly lower (P < 0.001) in the ibuprofen group compared to the control group. Acute renal failure occurred in three ibuprofen-treated patients (15%). CONCLUSIONS: Ibuprofen markedly reduces (59.4%) urinary PGE(2) and may alter renal function in the newborn.