AJP - Renal Physiology, Vol 254, Issue 1 38-F44, Copyright © 1988 by American Physiological Society
Indomethacin and patent ductus arteriosus: effects on renal function in preterm lambs
C. A. Gleason, R. I. Clyman, M. A. Heymann, F. Mauray, R. Leake and C. Roman
Cardiovascular Research Institute, University of California, San Francisco 94143.
To examine the independent effects of a patent ductus arteriosus and of
indomethacin therapy on the renal function of the preterm newborn, we
created a preterm lamb model in which ductus diameter could be regulated.
We studied 24 preterm newborn lambs. Eight lambs (group 1) had their ductus
closed at delivery and received no indomethacin. Eight lambs (group 2) had
their ductus closed and then received indomethacin (0.3 mg/kg) at 5.5 h;
eight lambs (group 3) had their ductus kept open and then received
indomethacin at 5.5 h. Hemodynamic and renal function measurements were
made at 5 h (pretreatment) and at 12.5 h. In group 2 lambs there was a
significant reduction in inulin clearance (GFR) and osmolal clearance after
indomethacin. In contrast, lambs with an open ductus (group 3), when
compared with lambs with a closed ductus (groups 1 and 2) at 5 h, already
had significantly decreased blood pressure, GFR, urine volume, and osmolal
clearance. Following indomethacin treatment, group 3 lambs showed no
further decrease in renal function. We suggest that in preterm lambs with
patent ductus, the apparent lack of renal dysfunction following
indomethacin treatment reflects underlying diminished renal function.
