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聚乙二醇加抗坏血酸用于慢性肾脏病患者的肠道准备

Polyethylene glycol plus ascorbic acid for bowel preparation in chronic kidney disease.

作者信息

Lee Jae Min, Keum Bora, Yoo In Kyung, Kim Seung Han, Choi Hyuk Soon, Kim Eun Sun, Seo Yeon Seok, Jeen Yoon Tae, Chun Hoon Jai, Lee Hong Sik, Um Soon Ho, Kim Chang Duck, Kim Myung Gyu, Jo Sang Kyung

机构信息

Division of Gastroenterology and Hepatology Division of Nephrology, Department of Internal Medicine, Korea University College of Medicine, Seongbuk-gu, Seoul, 02841, Korea.

出版信息

Medicine (Baltimore). 2016 Sep;95(36):e4755. doi: 10.1097/MD.0000000000004755.

Abstract

The safety of polyethylene glycol plus ascorbic acid has not been fully investigated in patients with renal insufficiency. High-dose ascorbic acid could induce hyperoxaluria, thereby causing tubule-interstitial nephritis and renal failure. This study aims to evaluate the safety and efficacy of polyethylene glycol plus ascorbic acid in patients with chronic kidney disease.We retrospectively reviewed prospectively collected data on colonoscopy in patients with impaired renal function. Patients were divided into 2 groups: 2 L polyethylene glycol plus ascorbic acid (n = 61) and 4 L polyethylene glycol (n = 80). The safety of the 2 groups was compared by assessing the differences in laboratory findings before and after bowel cleansing.The laboratory findings were not significantly different before and after the administration of 2 L polyethylene glycol plus ascorbic acid or 4 L polyethylene glycol. In both groups, the estimated glomerular filtration rate was not influenced by the administration of the bowel-cleansing agent. Patients' reports on tolerance and acceptability were better in the 2 L polyethylene glycol plus ascorbic acid group than in the 4 L polyethylene glycol group.The 2 L polyethylene glycol plus ascorbic acid solution is a safe choice for bowel preparation before colonoscopy in patients with impaired renal function.

摘要

聚乙二醇加抗坏血酸在肾功能不全患者中的安全性尚未得到充分研究。高剂量抗坏血酸可诱发高草酸尿症,进而导致肾小管间质性肾炎和肾衰竭。本研究旨在评估聚乙二醇加抗坏血酸在慢性肾脏病患者中的安全性和有效性。我们回顾性分析了前瞻性收集的肾功能受损患者结肠镜检查的数据。患者分为两组:2L聚乙二醇加抗坏血酸组(n = 61)和4L聚乙二醇组(n = 80)。通过评估肠道清洁前后实验室检查结果的差异来比较两组的安全性。给予2L聚乙二醇加抗坏血酸或4L聚乙二醇前后,实验室检查结果无显著差异。在两组中,估计肾小球滤过率均不受肠道清洁剂给药的影响。2L聚乙二醇加抗坏血酸组患者对耐受性和可接受性的报告优于4L聚乙二醇组。对于肾功能受损的患者,2L聚乙二醇加抗坏血酸溶液是结肠镜检查前肠道准备的安全选择。

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