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News

Risk of further decline in renal function after bowel preparations for colonoscopy

This month’s issue of the American Journal of Gastroenterology examines the risk of further decline in renal function after the use of oral sodium phosphate or polyethylene glycol for colonoscopy procedures.

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Dr Stefan Russmann and colleagues from Virginia, USA estimated the risk of further creatinine increase in patients with preexisting renal disease after the use of oral sodium phosphate versus polyethylene glycol.

The team undertook a cohort study using clinical records and electronic patient information from the Henry Ford Health System.

Patients were assessed who had used either oral sodium phosphate or polyethylene glycol for colonoscopy between 1999 and 2006.

Among patients with an estimated glomerular filtration rate less than 60 ml/min before colonoscopy, the team identified cases with an unexplained creatinine increase of 0.5 mg/dl or more within 14 days after colonoscopy.

The researchers identified 7971 oral sodium phosphate and 1511 polyethylene glycol users.

Relative use of oral sodium phosphate versus polyethylene glycol decreased from 88% before 2004 to 48% in 2006.

Oral sodium phosphates vs polyethylene glycol have a higher renal dysfunction risk
American Journal of Gastroenterology

The researchers found that 70% of oral sodium phosphate users had no recorded creatinine determination within 60 days before colonoscopy, and this proportion did not decrease over time.

The study population included 317 patients with a baseline glomerular filtration rate less than 60 ml/min.

The team identified 1 case with an unexplained creatinine increase of 0.5 mg/dl or more among less than 1% of polyethylene glycol users vs 6% of 126 oral sodium phosphate users.

Unadjusted and adjusted relative risk estimates on comparing oral sodium phosphate with polyethylene glycol were 12 and 13, respectively.

Dr Russmann’s team commented, “In patients with preexisting renal disease, oral sodium phosphate use was associated with an increased risk of aggravated renal dysfunction versus polyethylene glycol.” 

Am J Gastroenterol 2008: 103(11): 2707-16


05 November 2008

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