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

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.