Lee Sang Pyo, Park Eugene, Kim Han Viet, Sung In-Kyung, Kim Jeong Hwan, Lee Sun-Young, Park Hyung Seok, Shim Chan Sup
Department of Internal Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 143-729, Korea.
School of Medicine, The University of Melbourne, Melbourne, Australia.
Dig Dis Sci. 2016 Nov;61(11):3207-3214. doi: 10.1007/s10620-016-4297-9. Epub 2016 Sep 13.
The use of polyethylene glycol (PEG)-based solutions is the gold standard for bowel preparation. However, PEG use might be associated with the risk of acute kidney injury.
We aimed to compare the safety of 2 L PEG plus ascorbic acid (AA) versus 4 L PEG.
Health examinees that underwent colonoscopy and blood tests on the same day at our center were included in this retrospective study. All subjects were prescribed either 2 L PEG plus AA or 4 L PEG for the bowel preparation prior to the colonoscopy. The incidences of electrolyte imbalance and renal impairment after colonic preparation were investigated. Renal impairment was determined if the subject's estimated glomerular filtration rate was measured less than 60 mL/min/1.73 m.
Of the 29,789 cases, 14,790 received 2 L PEG plus AA (group A) and 14,999 received 4 L PEG (group B) for colonic preparation. Renal impairment occurred more commonly in group A (n = 467, 3.2 %) than in group B (n = 189, 1.3 %). Electrolyte changes such as hypernatremia and hyperkalemia were more common in group A than group B, whereas hyponatremia, hypokalemia, and hypophosphatemia were more common in group B than group A. Old age, male sex, and the use of 2 L PEG plus AA were independent risk factors for renal impairment.
The evidence strongly suggests that acute kidney injury is more likely to occur when 2 L PEG plus AA is used for the bowel preparation than when 4 L PEG is used.
KCT0001703.
使用基于聚乙二醇（PEG）的溶液是肠道准备的金标准。然而，使用PEG可能与急性肾损伤风险相关。
我们旨在比较2L PEG加抗坏血酸（AA）与4L PEG的安全性。
本回顾性研究纳入了在我们中心同一天接受结肠镜检查和血液检查的健康体检者。所有受试者在结肠镜检查前均被处方2L PEG加AA或4L PEG进行肠道准备。调查结肠准备后电解质失衡和肾功能损害的发生率。如果受试者的估计肾小球滤过率测量值低于60 mL/min/1.73 m²，则判定为肾功能损害。
在29789例病例中，14790例接受2L PEG加AA（A组）进行结肠准备，14999例接受4L PEG（B组）。A组肾功能损害的发生率（n = 467，3.2%）高于B组（n = 189，1.3%）。高钠血症和高钾血症等电解质变化在A组比B组更常见，而低钠血症、低钾血症和低磷血症在B组比A组更常见。老年、男性以及使用2L PEG加AA是肾功能损害的独立危险因素。
有力证据表明，与使用4L PEG进行肠道准备相比，使用2L PEG加AA时更易发生急性肾损伤。
KCT0001703。
