J Pediatr Intensive Care 2020; 09(03): 155-161
DOI: 10.1055/s-0040-1705178
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Xanthine Derivatives for Kidney Protection in the Critically Ill Pediatric Population: A Systematic Review

Saul Flores
1  Division of Critical Care and Cardiology, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, United States
,
Corissa N. Culichia
2  Division of Cardiology, Department of Pediatrics, Advocate Children's Hospital, Oak Lawn, Illinois, United States
,
Enrique G. Villarreal
1  Division of Critical Care and Cardiology, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, United States
3  Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
,
Fabio Savorgnan
1  Division of Critical Care and Cardiology, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, United States
,
Paul A. Checchia
1  Division of Critical Care and Cardiology, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, United States
,
Rohit S. Loomba
2  Division of Cardiology, Department of Pediatrics, Advocate Children's Hospital, Oak Lawn, Illinois, United States
› Author Affiliations
Further Information

Publication History

15 October 2019

27 January 2020

Publication Date:
09 March 2020 (online)

Abstract

Different types of diuretics have been used to minimize fluid overload after resuscitation. This meta-analysis determined the effects of xanthine derivatives on creatinine, creatinine clearance, and urine output. Studies included data from pediatric patients, whoused theophylline or aminophylline, and included pre- and postxanthine data for at least one of the outcomes of interest. A total of 13 studies with 198 patients were included in the pooled analyses. The study recorded data prior, and a mean of 36 hours after xanthine administration. This meta-analysis demonstrates that xanthine derivatives in critically ill children, using a dose of approximately5 mg/kg, lead to a statistically significant increase in creatinine clearance and urine output without significantly altering serum creatinine. Xanthine derivatives may be beneficial for fluid management in critically ill children. Further studies are warranted assessing the association with additional clinical outcomes.

Supplementary Material