346 Neonatal Treatment Toxicity on Day 7 and Throughout the First Month of Life

Abstract

Background and aims: Preterm infants are at high risk of drug-induced acute kidney injury. We aimed to determine the impact on GFR during the first month of life, of the drugs prescribed shortly after birth in the Neonatal Intensive Care Units.

Methods: multicenter study nested in a cohort of 27-31 weeks GA infants. Infants parted into two groups: “Low GFR”: GFR day7< median GFR for GA; “High GFR”: GFR day7 ≥ median GFR for GA GFR was measured weekly for one month and analyzed with a logistic regression model and an ANOVA with repeated measures (drug and time effects throughout the first month).

Results: 269 infants included. Nephrotoxic drugs prescribed before day7 were mainly aminoglucosides, glycopeptides, and Cox-inhibitors. Cox-inhibitors were far the most nephrotoxic drugs, and GFR remained low for the first month of life after Cox-inhibitor administration. Even high plasmatic levels of aminoglycosides or of glycopeptides did not reach the nephrotoxic effect of Cox-inhibitors:

Table

Table

Conclusion: If GFR day7 < median reference value, and infants have received ibuprofen, blood levels of other potentialy nephrotoxic drugs should be closely monitored.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD