ABSTRACT
Non-steroidal antiinflammatory drugs (NSAIDs) are used in neonates in different clinical conditions. They selectively inhibit cyclo-oxygenases (COXs) -1 and -2 which synthesise prostanoids [1]. The developmental kidney is highly dependent on prostanoids and this explains the provocative title. Many studies exploring the action of prostaglandins on the kidney have been done in adult animals or in adult tissue (in vitro data). Extrapolating the results of these studies to the immature human kidney therefore has to be made with caution. Nevertheless, they help one understand the pharmacokinetic/pharmacodynamic (PK/PD) relationship of NSAIDs, especially regarding toxicity in the neonate. Indomethacin is the main drug belonging to the NSAIDs class, which has been used in premature infants and most of the studies in these neonates refer to this drug, while new experimental data are now available for ibuprofen.
