Theophylline-induced diuresis in the neonate

Nobel, Patricia A.; Light, Gerald S.

doi:10.1016/s0022-3476(77)81262-6

Cited by 19 publications

(3 citation statements)

References 4 publications

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“…Our data do not show that aminophylline, associated or not with steroids, could interfere with hydrosaline equilibrium, nor with plasma osmolality of the preterm at birth, nor accelerate maturation of renal function in immature infants. However, later on, in the treatment of apnea, aminophylline induces an increase in the GFR, and others have descibed dehydration and hyponatremia that persisted until the drug's discontinuation [16,21]. In the current study specific investigations were not undertaken in these aspects, and will be the subject of future study.…”

Section: Discussionmentioning

confidence: 99%

Antenatal aminophylline and steroid exposure: Effects on glomerular filtration rate and renal sodium excretion in preterm newborns

Zanardo¹,

Giacobbo²,

Zambon³

et al. 1990

Jpme

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Creatinine clearance and renal sodium excretion were measured consecutively in three groups of 12 premature infants (gestational age less than or equal to 35 weeks) whose mothers had received either steroids or aminophylline, or steroids and aminophylline before delivery. We found no significant differences for plasma and urine creatinine and its clearance in the groups considered. The steroid group presented urine osmolality and urine/plasma osmolality ratio significantly higher than among the other groups. Furthermore, urine potassium excretion increased, and urine sodium and sodium fractional excretion were reduced. Aminophylline exposure did not interfere with the hydrosaline equilibrium nor with renal function of the preterms at birth. Our results reconfirm that corticosteroid hormones play an important part in the fetal renal maturation process, inducing a precocious maturation of the tubular Na(+)-K+ ATPase enzymatic system, that is substantially unmodified by aminophylline exposure. However, due to the prolonged half-life of aminophylline in prematures, it seems reasonable to verify the coupling of tubular and glomerular functions also in the following days of life.

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Section: Discussionmentioning

confidence: 99%

Antenatal aminophylline and steroid exposure: Effects on glomerular filtration rate and renal sodium excretion in preterm newborns

Zanardo¹,

Giacobbo²,

Zambon³

et al. 1990

Jpme

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“…In premature newborns, methylxanthines may induce significant changes in the glomerular filtration rate and natriuresis; thus, an effect on urine calcium excretion can be expected [4,5], Therefore, the aim of our study was to determine whether a short course of caffeine and theophylline in preterm infants could be associated with changes in urine excretion of calcium.…”

Section: Introductionmentioning

confidence: 99%

Methylxanthines Increase Renal Calcium Excretion in Preterm Infants

Zanardo¹,

Dani²,

Trevisanuto³

et al. 1995

Neonatology

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To determine the effect of a short course of methylxanthines on renal function and on urinary calcium excretion, 20 premature neonates affected by apnea or moderate respiratory distress syndrome were randomly assigned to either a theophylline treatment or to a caffeine treatment group. The protocol included a 24-hour pretreatment study period (I) and a subsequent 24-hour period (II) following 5 days of theophylline (loading dose 5 mg/kg i.v., maintenance dose 2.5 mg/kg/l2 h) or caffeine (loading dose 10 mg/kg i.v., maintenance dose 2.5 mg/kg/l2 h) administration. Pre- and postxanthine treatment serum sodium, potassium, calcium and phosphorus remained stable, while serum creatinine decreased significantly (p < 0.05). Furthermore, from period I to period II, sodium urine excretion, fractional Na excretion and creatinine clearance remained statistically comparable in both study groups, along with a significant increase (p < 0.05) in calciuria, urinary Ca/creatinine and urinary Ca/Na. Predose caffeine and theophylline serum levels, assessed on the 5th day of treatment, were 12.8 ± 1.8 and 7.9 ± 1.7 μg/ml, respectively. Compared to control healthy untreated prematures, the studied premature infants showed a statistically significant increase in urine calcium excretion (10- to 15-fold), which was more evident in the theophylline group. Our data suggest further investigation to determine the long-term renal effects of methylxanthines in premature neonates, to improve assessment of the risk of nephrocalcinosis and osteopenia, in particular in association with various diuretic therapies.

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“…4 There are few studies with conflicting results regarding the effects of aminophylline on renal function in premature infants. 5 " 9 Nobel and Light 5 reported diuresis and dehydration in a 28week gestation infant coinciding with theophylline therapy. In contrast, Shannon and Gotay 6 did not observe any change in serum electrolytes or in renal excretion of sodium or water in 10 infants with apnea treated with aminophylline as compared to agematched controls.…”

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confidence: 99%

Effects of Theophylline on Renal Function in Premature Infants

Mazkereth¹,

Laufer²,

Jordan³

et al. 1997

Amer J Perinatol

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Xanthines are frequently being used in the management of premature babies. Studies in adult subjects have demonstrated a diuretic effect of aminophylline due to the inhibition of solute reabsorption in various segments of the nephron. We evaluated the effects of aminophylline on the developing kidney. Nineteen premature infants, with a mean +/- SD gestational age of 31.1 +/- 2.8 weeks and mean birth weight of 1481 +/- 454 g were studied at mean age of 4.5 +/- 4.0 days before and after a 20-minute loading infusion of 6 mg/kg aminophylline, followed by maintenance therapy at a dose of 2 mg/kg every 12 hours. A marked diuresis occurred immediately after the loading dose, the ratio of urinary output to water intake increased from 0.58 +/- 0.36 to 1.19 +/- 0.65. Concomitantly, the fractional excretion of sodium increased from 2.7 +/- 2.6% to 5.7 +/- 4.4% and that of potassium rose from 21 +/- 19% to 31 +/- 21%. Urinary calcium and uric acid excretion were also enhanced: calcium to creatinine ratio rose from 0.31 +/- 0.29 to 0.60 +/- 0.54 and uric acid to creatinine ratio increased from 2.5 +/- 1.5 to 3.8 +/- 2.0. Tubular reabsorption of phosphorus (TRP) was not affected. Most of the effects were no longer evident after 24 hours, despite continuing aminophylline maintenance therapy. In premature infants the aminophylline loading dose, but not maintenance therapy, affected renal functions. Because heart rate, blood pressure, and creatinine clearance did not change, it appears that aminophylline acts directly on tubular reabsorptive functions.

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Theophylline-induced diuresis in the neonate

Cited by 19 publications

References 4 publications

Antenatal aminophylline and steroid exposure: Effects on glomerular filtration rate and renal sodium excretion in preterm newborns

Antenatal aminophylline and steroid exposure: Effects on glomerular filtration rate and renal sodium excretion in preterm newborns

Methylxanthines Increase Renal Calcium Excretion in Preterm Infants

Effects of Theophylline on Renal Function in Premature Infants

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