Theophylline to treat asphyxial renal failure in the newborn

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Birth asphyxia commonly results in acute kidney dysfunction that, fortunately, generally resolves. The increase in adenosine that occurs with asphyxia can cause arteriolar vasoconstriction in the kidney. The adenosine receptor antagonist theophylline can block that vasoconstriction and improve kidney function in experimental animals. With a randomized controlled trial, Bhat et al now show that theophylline treatment of term birth asphyxiated infants can improve kidney function over the first days of life. By 6 months of age, renal function had normalized in both the theophylline treated and control infants. This study is a clear demonstration of a physiological effect of theophylline on kidney function in the asphyxiated infant. Far more infants would need to be studied to evaluate any persistent benefit.

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