Information de reference pour ce titreAccession Number: | 00005186-200608000-00011.
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Author: | BHAT, MUSHTAQ A. MD; SHAH, ZAFFAR A. PHD; MAKHDOOMI, MUDASIR S. DCH; MUFTI, MASOOD H. MD
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Institution: | Departments of Pediatrics and Immunology, Shere-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, Kashmir, India
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Title: | |
Source: | Journal of Pediatrics. 149(2):180-184, August 2006.
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Abstract: | Objective: To study whether prophylactic theophylline can reduce the incidence and/or severity of renal failure in term infants with perinatal asphyxia.
Study design: Term neonates with severe perinatal asphyxia were randomized to receive a single dose of either theophylline (study group, n = 40) or placebo (control group, n = 30) during the first hour of life. Daily weight, output/input ratio, 24-hour fluid intake, and urine volumes were recorded during the first 5 days of life. Those infants with asphyxial renal failure were followed up for 1 year.
Results: The incidence of severe renal dysfunction was increased in the control group. Creatinine clearance was higher and excretion of beta 2 microglobulin ([beta]2M) was lower in the theophylline group. Conversely, the glomerular filtration rate was lower in the control group. In infants with renal failure, serum creatinine and creatinine clearance returned to normal in the neonatal period, and the increased [beta]2M excretion normalized by age 6 weeks.
Conclusions: A single dose of theophylline within the first hour of birth in term neonates with perinatal asphyxia results in a significant decrease in serum creatinine level and urinary excretion of [beta]2M, along with an increase in creatinine clearance.
(C) Mosby-Year Book Inc. 2006. All Rights Reserved.
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References: | 1. Martin-Ancel A, Garcia-Alix A, Gaya F, Cabanas F, Burgueros M, Quero J. Multiple organ involvement in perinatal asphyxia. J Pediatr 1995;127:786-793.
2. Perlman JM, Tack ED, Martin T, Shackelford G, Amon E. Acute systemic organ injury in term infants after asphyxia. Am J Dis Child 1989;143:617-620.
3. Shankaran S, Woldt E, Koepke T, Bedard MP, Nandyal R. Acute neonatal morbidity and long-term central nervous system sequelae of perinatal asphyxia in term infants. Early Hum Dev 1991;25:135-148.
4. Gunn AJ, Gluckman PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: a safety study. Pediatrics 1998;102:885-892.
5. Gouyon JB, Guignard JP. Theophylline prevents hypoxemia-induced renal hemodynamic changes in rabbits. Kidney Int 1988;33:1078-1083.
6. Busch EW, von Borcke IM, Martinez B. Pathway and pattern for purine nucleotide catabolism in rabbit heart, liver and kidney tissues during circulation stasis. Biochim Biophys Acta 1968;166:547-556.
7. Osswald H, Schmitz HJ, Kemper R. Tissue content of adenosine, inosine and hypoxanthine in the rat kidney after ischemia and postischemic recirculation. Pflugers Arch 1977;371:45-49.
8. Churchill PC, Bidani AK. Hypothesis: adenosine mediates hemodynamic changes in renal failure. Med Hypotheses 1982;8:275-285.
9. Osswald H. Renal effects of adenosine and their inhibition by theophylline in dogs. Naunyn Schmiedebergs Arch Pharmacol 1975;288:79-86.
10. Jenik AG, Ceriani Cernadas JM, Gorenstein A, Ramirez JA, Vain N, Armadans M, et al. A randomized, double-blind, placebo-controlled trial of the effects of prophylactic theophylline on renal function in term neonates with perinatal asphyxia. Pediatrics 2000;105:e45.
11. Di Pietro A, Proverbio MR, Pescatore L, Chianese F, Coletta S, Race G, et al. Evaluation of kidney damage in neonatal anoxia syndrome: a 1-year follow-up. Pediatr Med Chir 1989;11:637-638.
12. Kelly DH, Shannon DC. Treatment of apnea and excessive periodic breathing in the full-term infant. Pediatrics 1981;68:183-186.
13. Portman RJ, Carter BS, Gaylord MS, Murphy MG, Thieme RE, Merenstein GB. Predicting neonatal morbidity after perinatal asphyxia: a scoring system. Am J Obstet Gynecol 1990;162:174-182.
14. Cloherty JP, Stark AR, Eichenwald E. Manual of neonatal care. 5th ed. Philadelphia: Lippincott-Raven; 2003.
15. Tack ED, Perlman JM, Robson AM. Renal injury in sick newborn infants: a prospective evaluation using urinary beta 2-microglobulin concentrations. Pediatrics 1988;81:432-440.
16. Bowmer CJ, Collis MG, Yates MS. Effect of the adenosine antagonist 8-phenyltheophylline on glycerol-induced acute renal failure in the rat. Br J Pharmacol 1986;88:205-212.
17. Deray G, Martinez F, Cacoub P, Baumelou B, Baumelou A, Jacobs C. A role for adenosine calcium and ischemia in radiocontrast-induced intrarenal vasoconstriction. Am J Nephrol 1990;10:316-322.
18. Prada J, Churchill P, Bidani A. Protective effect of theophylline in endotoxin-mediated acute renal failure (ARF) in rats. Kidney Int 1986;29:308-312.
19. Gouyon JB, Guignard JP. Renal effects of theophylline and caffeine in newborn rabbits. Pediatr Res 1987;21:615-618.
20. Kemper R. The antagonist effects of adenosine and theophylline on renal functions of rats [MD thesis]. Aachen, Germany: University of Aachen, Germany; 1977.
21. Erley CM, Duda SH, Schlepckow S, Koehler J, Huppert PE, Strohmaier WL, et al. Adenosine antagonist theophylline prevents the reduction of glomerular filtration rate after contrast media application. Kidney Int 1994;45:1425-1431.
22. Huet F, Semama D, Grimaldi M, Guignard JP, Gouyon JB. Effects of theophylline on renal insufficiency in neonates with respiratory distress syndrome. Intensive Care Med 1995;21:511-514.
23. Laudignon N, Farri E, Beharry K, Rex J, Aranda JV. Influence of adenosine on cerebral blood flow during hypoxic hypoxia in the newborn piglet. J Appl Physiol 1990;68:1534-1541.
24. Willis F, Summers J, Minutillo C, Hewitt I. Indices of renal tubular function in perinatal asphyxia. Arch Dis Child Fetal Neonatal Ed 1997;77:F57-F60.
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Language: | English.
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Document Type: | ORIGINAL ARTICLE.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0022-3476
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NLM Journal Code: | jlz, 0375410
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