The effect of oral sodium phosphate drug products on renal function in adults undergoing bowel endoscopy - PubMed (original) (raw)
The effect of oral sodium phosphate drug products on renal function in adults undergoing bowel endoscopy
Anand Khurana et al. Arch Intern Med. 2008.
Abstract
Background: Oral sodium phosphate solution (OSPS) preparations are preferred cleansing agents for colonoscopy because of ease of use and excellent preparation quality. Besides causing acute renal failure in some patients, the high phosphorus content can potentially cause chronic kidney damage to patients undergoing colonoscopy.
Methods: We carried out a retrospective study on patients with creatinine levels in the normal range who had undergone colonoscopy or flexible sigmoidoscopy using OSPS preparation from January 1998 to February 2005 and followed them for 1 year to determine its effects on their renal function. A control group of patients with similar comorbidities during this period were chosen to assess age-related decline in renal function in this population.
Results: A total of 286 patients were selected in the study group, and 125 patients were selected in the control group. Both groups had similar baseline characteristics. The baseline glomerular filtration rate (GFR) in the study group was 79 mL/min/1.73 m(2), which declined to 73 mL/min/1.73 m(2) at 6 months after exposure to OSPS preparation. This finding was significantly different from the control group, in whom the baseline GFR was 76 mL/min/1.73 m(2) and remained stable at 6 months. Linear regression analysis showed that use of angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers and the presence of diabetes were significant determinants of the fall in GFR after use of OSPS preparation.
Conclusions: Oral sodium phosphate solution preparation is associated with decline in GFR in elderly patients with creatinine levels in the normal range. Its routine use for elective and screening procedures should be discouraged in the elderly population.
Comment in
- Purging the colon while preserving the kidneys.
Roy HK, Bianchi LK. Roy HK, et al. Arch Intern Med. 2008 Mar 24;168(6):565-7. doi: 10.1001/archinte.168.6.565. Arch Intern Med. 2008. PMID: 18362246 No abstract available. - Consideration of extrarenal creatinine clearance in the measurement of renal function after bowel endoscopy.
Seifter JL, Fuller AP. Seifter JL, et al. Arch Intern Med. 2008 Oct 27;168(19):2166-7. doi: 10.1001/archinte.168.19.2166. Arch Intern Med. 2008. PMID: 18955649 No abstract available. - No black box on phosphosoda.
Caswell M. Caswell M. Arch Intern Med. 2008 Nov 10;168(20):2285-6. doi: 10.1001/archinte.168.20.2285-b. Arch Intern Med. 2008. PMID: 19001209 No abstract available. - Oral sodium phosphate drug products and renal function.
Abbott KC, Bohen EM, Hurst FP. Abbott KC, et al. Arch Intern Med. 2008 Nov 10;168(20):2285. doi: 10.1001/archinte.168.20.2285-a. Arch Intern Med. 2008. PMID: 19001210 No abstract available. - Oral sodium phosphate and renal function.
Cohen LB. Cohen LB. Arch Intern Med. 2008 Nov 10;168(20):2286; author reply 2286-7. doi: 10.1001/archinte.168.20.2286-a. Arch Intern Med. 2008. PMID: 19001211 No abstract available.
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