The renal safety of bowel preparations for colonoscopy: a comparative study of oral sodium phosphate solution and polyethylene glycol

Aliment Pharmacol Ther. 2008 Jan 1;27(1):41-7. doi: 10.1111/j.1365-2036.2007.03558.x. Epub 2007 Oct 23.

Abstract

Background: Rare cases of nephrotoxicity have been reported with oral sodium phosphate solution (OSPS).

Aim: To evaluate whether OSPS is associated with changes in renal function.

Methods: A chart review performed on 311 patients who had colonoscopy at the James J. Peters VA Medical Centre prepared with either OSPS (n = 157) or polyethylene glycol (PEG) (n = 154). Patients had a baseline serum creatinine <or=1.5 mg/dL. Effect of bowel preparation on the renal function was evaluated by measuring the absolute change in levels of serum creatinine and the proportion of patients who developed a 50% or more increase above their baseline serum creatinine value.

Results: Oral sodium phosphate solution resulted in a slight increase in serum creatinine from 1.0 +/- 0.02 to 1.1 +/- 0.02 mg/dL (P = 0.07) and PEG resulted in a small decrease in serum creatinine from 1.1 +/- 0.02 to 1.0 +/- 0.03 mg/dL (P = 0.03). The absolute change in serum creatinine was slightly higher with OSPS than with PEG (0.04 +/- 0.02 vs. -0.05 +/- 0.02 mg/dL; P = 0.005). However, the proportion of patients who had a >or=50% increase above their baseline creatinine was similar (OSPS vs. PEG, 5% vs. 3%, P = 0.77).

Conclusions: Oral sodium phosphate solution was associated with a slight increase in serum creatinine, which was not clinically significant. Renal toxicity from OSPS appears to be minimal when used in patients with serum creatinine value <1.5 mg/dL.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Aged
  • Cathartics / adverse effects*
  • Colonoscopy / adverse effects*
  • Colonoscopy / methods
  • Creatinine / blood
  • Female
  • Humans
  • Kidney / drug effects*
  • Male
  • Middle Aged
  • Phosphates / administration & dosage
  • Phosphates / adverse effects*
  • Polyethylene Glycols / adverse effects*
  • Regression Analysis
  • Retrospective Studies
  • Therapeutic Irrigation

Substances

  • Cathartics
  • Phosphates
  • Polyethylene Glycols
  • Creatinine
  • sodium phosphate