Urinary Prostaglandins and the Effect of Indomethacin on Phosphate Excretion in Children With Hypophosphatemic Rickets

• Published in: Pediatric research Vol. 64; no. 2; pp. 210 - 212
• Main Authors: Seikaly, Mouin G, Waber, Pamela G, Baum, Michel
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.08.2008; Lippincott Williams & Wilkins
• Subjects: Adolescent; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Biological and medical sciences; Child; Child, Preschool; clinical-investigation; Creatinine - urine; Cross-Over Studies; Dinoprostone - urine; Double-Blind Method; Familial Hypophosphatemic Rickets - drug therapy; Familial Hypophosphatemic Rickets - urine; Female; General aspects; Genetic Diseases, X-Linked; Humans; Indomethacin - therapeutic use; Male; Medical sciences; Medicine; Medicine & Public Health; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Pediatric Surgery; Pediatrics; Phosphates - urine; Phosphorus - blood; Prospective Studies; Prostaglandins - urine; Tubulopathies; Phosphates; Prostaglandin-endoperoxide synthase; Pediatrics; Diseases of the osteoarticular system; Tubulopathy; Indometacin; Hypophosphatemic rickets; Tocolytic; Vitamin D; Eicosanoid; Indoleacetic acid derivatives; Child; Human; Kidney disease; Urine; Excretion; Urinary system disease; Prostaglandin; Enzyme; Arachidonic acid derivatives; Enzyme inhibitor; Metabolic diseases; Genetic disease; Non steroidal antiinflammatory agent; Vitamin resistant rickets; Oxidoreductases
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1203/PDR.0b013e318175d788

We recently reported the urinary prostaglandin E 2 /creatinine ratio (PGE 2 /Cr) was markedly elevated in Hyp mice, the animal model for X-linked hypophosphatemia, compared with control mice. We provided evidence for altered prostaglandin production mediating the phosphaturia and that indomethacin decreases urinary phosphate excretion in Hyp mice but not control mice. To determine the levels of urinary PGE 2 /Cr, the safety and efficacy of indomethacin on phosphate excretion in children with hypophosphatemic rickets (HPR), a prospective clinical trial was performed in 16 children with HPR and 16 age- and gender-matched healthy controls. Urinary PGE 2 /Cr excretion was determined on a 24 h timed urine collection. A randomized cross over, placebo versus indomethacin, clinical trial was performed in the 16 children with HPR. There was no difference in urinary PGE 2 /Cr excretion between controls and patients with HPR. In children with HPR, indomethacin treatment for 3 mo had no significant effect on serum phosphorus or urinary phosphate excretion. In conclusion, urinary prostaglandin excretion is similar in children with HPR compared with controls. Indomethacin had no significant effect on serum phosphorus or urinary phosphate excretion in children with HPR.