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

To investigate changes in urinary PGE(2) after ibuprofen treatment in preterm infants with patent ductus arteriosus (PDA). 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. 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%). Ibuprofen markedly reduces (59.4%) urinary PGE(2) and may alter renal function in the newborn.