Efects of aminophylline therapy on urine output and kidney function in children with acute kidney injury

Abstract

Background Acute kidney injury (AKI) is a frequent complication of children admitted to the paediatric intensive care unit. One key management modality of AKI is the use of diuretics to reduce fuid overload. Aminophylline, a drug that is well known for its use in the treatment of bronchial asthma, is also purported to have diuretic efects on the kidneys. This retrospective cohort study assesses the efect of aminophylline in critically ill children with AKI. Methods A retrospective chart review of children admitted to the paediatric intensive care unit of the Red Cross War Memo rial Children’s Hospital (RCWMCH) with AKI who received aminophylline (from 2012 to June 2018) was carried out. Data captured and analyzed included demographics, underlying disease conditions, medications, urine output, fuid balance, and kidney function. Results Data from thirty-four children were analyzed. Urine output increased from a median of 0.4 mls/kg/hr [IQR: 0.1, 1.1] at six hours prior to aminophylline administration to 0.6 mls/kg/hr [IQR: 0.2, 1.9] at six hours and 1.6 mls/kg/hr [IQR:0.2, 4.2] at twenty-four hours post aminophylline therapy. The median urine output signifcantly varied across the age groups over the 24-h time period post-aminophylline, with the most response in the neonates. There was no signifcant change in serum creatinine levels six hours post-aminophylline administration [109(IQR: 77, 227)—125.5(IQR: 82, 200) micromole/l] P-value=0.135. However, there were signifcant age-related changes in creatinine levels at six hours post-aminophylline therapy. Conclusions Aminophylline increases urine output in critically ill children with AKI