Ohmiya Naoki, Nakagawa Yoshihito, Horiguchi Noriyuki, Omori Takafumi, Kamano Toshiaki, Funasaka Kohei, Nagasaka Mitsuo, Shibata Tomoyuki
Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Gastroenterol Res Pract. 2021 Mar 15;2021:6696591. doi: 10.1155/2021/6696591. eCollection 2021.
Polyethylene glycol-electrolyte lavage solution plus ascorbic acid (PEG-ELS-Asc) has been recommended for colonoscopy, but little is known about the safety of PEG-ELS-Asc in patients with chronic kidney disease (CKD). The aim of this study was to determine its safety and efficacy in CKD patients.
Blood and urine samples prospectively collected before and after same-day bowel preparation for colonoscopy with the conventional volume of PEG-ELS-Asc, vital signs before and after colonoscopy, and adverse events within 30 days postcolonoscopy were analyzed in consenting patients with CKD. The cleansing level was evaluated with the Boston bowel preparation score (BBPS) from colonoscopic findings.
Of 57 patients enrolled, 1 was excluded for refusal. Serum bicarbonate significantly dropped, and blood hemoglobin, serum total protein, albumin, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, total bilirubin, and uric acid significantly rose after bowel preparation, although these changes were not clinically important. Only in nondialysis patients did the platelet count and potassium significantly rise, although these changes were not clinically important either. Renal function, such as the urea, creatinine, and estimated glomerular filtration rate, was not significantly altered. An adequate bowel cleansing score, BBPS ≥ 6, was achieved in 94% of patients. The blood pressure and heart rate were not significantly different between before and after colonoscopy in either nondialysis ( = 32) or dialysis ( = 19) patients. There were no adverse events associated with bowel preparation and colonoscopy within 30 days postcolonoscopy.
The conventional volume of same-day bowel preparation with PEG-ELS-Asc may be safe and effective in CKD patients.
聚乙二醇电解质灌洗液加抗坏血酸（PEG-ELS-Asc）已被推荐用于结肠镜检查，但对于慢性肾脏病（CKD）患者使用PEG-ELS-Asc的安全性知之甚少。本研究的目的是确定其在CKD患者中的安全性和有效性。
对同意参与研究的CKD患者，前瞻性收集其在使用常规剂量的PEG-ELS-Asc进行当日结肠镜检查肠道准备前后的血液和尿液样本、结肠镜检查前后的生命体征以及结肠镜检查后30天内的不良事件。根据结肠镜检查结果，用波士顿肠道准备评分（BBPS）评估肠道清洁程度。
在纳入的57例患者中，1例因拒绝参与被排除。肠道准备后血清碳酸氢盐显著下降，而血红蛋白、血清总蛋白、白蛋白、天冬氨酸转氨酶、丙氨酸转氨酶、乳酸脱氢酶、总胆红素和尿酸显著升高，尽管这些变化在临床上并不重要。仅在未透析患者中血小板计数和钾显著升高，尽管这些变化在临床上也不重要。肾功能，如尿素、肌酐和估计肾小球滤过率，没有显著改变。94%的患者达到了足够的肠道清洁评分，即BBPS≥6。未透析患者（n = 32）和透析患者（n = 19）结肠镜检查前后的血压和心率均无显著差异。结肠镜检查后30天内没有与肠道准备和结肠镜检查相关的不良事件。
CKD患者使用常规剂量的当日PEG-ELS-Asc进行肠道准备可能是安全有效的。
