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KMID : 0351819980390010051
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Kyunpook University Medical Journal
1998 Volume.39 No. 1 p.51 ~ p.59
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Renal Effect of Theophylline in Apnea of Prematurity
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Kim Soo-Young
Kim Haeng-Mi
Choe Byung-Ho
Lee Kun-Soo
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Abstract
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Purpose:Theophylline is frequently being used in the management of apnea of prematurity. Studies in adult subjects have demonstrated a diuretic, natriuretic and <:alciuretic effects of theophylline. In premature infants the increased urinary calcium excretion may induce nephrocalcinosis and osteopenia. Therefore the aim of this study was to determine whether theopliylline in premature infants could be associated with changes in urine excretion of calcium.
Methods :Twelve premature infants with mean gestational age of 32.1 2.9 weeks and mean birth weight of 1841 ~´ 45gm were studied. Before and 5 days after initiation of aminophylline, water, calories and calcium intakes were determined. Each time, serum Na, K, Ca, ionized Ca, P, alkaline phosphatase, creatinine, glucose, serum theophylline level, 24 hour urine volume, urinay Ca, Na and creatinine were evaluated.
The following indices were calculated; creatinine clearance; fractional excretion of sodium and calcium; urinary sodium and calcium to creatinine ratio.
Results :Before and 5 days after initiation of theophylline therapy, there were no changes in serum electrolyte, creatinine and alkaline phosphatase. Creatinine clearance, fractional excretion of sodium, fractional excretion of calcium, urinary sodium/creatinine and tuznary calcium/ creatinine were not enhanced by aminophylline. Four cases of hyperglycemia, 3 cases of irritability and tachycardia were observed during aminophylline therapy.
Conclusions: In premature infants the theophylline therapy did not affect renal functions. Because creatinine clearance, fracrional excretion of sodium and calcium did not change before and after administration, it appears that theophylline did not act as a risk for nephrocalcinosis or osteopenia in prematurity.
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KEYWORD
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prematurity, apnea, urinary Ca excretion
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