Kidney injury and other complications related to colonoscopy in inpatients at a tertiary teaching hospital

Ivanovic, Ligia Fidelis; Silva, Bruno C. da; Lichtenstein, A.; Paiva, Edison Ferreira de; Bueno-Garcia, Maria Lucia

doi:10.6061/clinics/2018/e456

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…Apart from acute kidney injury due to bowel preparation solutions[ 25 ], direct physical injuries to the kidney(s) or supra-renal gland(s) by colonoscopy was not reported.…”

Section: Other Abdominal Organ Injuries During Colonoscopymentioning

confidence: 99%

Trauma to the solid abdominal organs: The missed dark box of colonoscopy

Emara,

Mazid,

Elshaer

et al. 2024

World J Gastroenterol

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Colonoscopy is an integral part of the lower bowel care and is generally considered a potentially safe diagnostic and therapeutic procedure performed as a daycare outpatient procedure. Colonoscopy is associated with different complications that are not limited to adverse events related to the bowel preparation solutions used, the sedatives used, but to the procedure related as well including bleeding and perforation. Injuries to the extra-luminal abdominal organs during colonoscopy are uncommon, however, serious complications related to the procedure have been reported infrequently in the literature. Life threatening injuries to the spleen, liver, pancreas, mesentery, and urinary bladder have been reported as early as in mid-1970s. These injuries should not be overlooked by clinicians and endoscopists. Steadily increasing abdominal pain, abdominal distension, and hemodynamic instability in absence of rectal bleeding should raise the possibility of severe organ injury. Splenic and hepatic injury following colonoscopy are usually serious and may be life threatening. Although conservative management may help, yet they usually need interventional radiology or surgical intervention. Acute pancreatitis following colonoscopy is usually mild and is mostly managed conservatively. The mechanism of abdominal organ injuries during colonoscopy is not fully understood, however many risk factors have been identified, which can be classified as- organ related, procedure related, and local abdominal factors. Difficult colonoscopy and prior intra-abdominal adhesions are probably the most relevant risk factors for these injuries. Left lateral position, avoidance of looping and excessive force during the procedure would probably reduce the risk of such injuries.

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“…Apart from acute kidney injury due to bowel preparation solutions[ 25 ], direct physical injuries to the kidney(s) or supra-renal gland(s) by colonoscopy was not reported.…”

Section: Other Abdominal Organ Injuries During Colonoscopymentioning

confidence: 99%

Trauma to the solid abdominal organs: The missed dark box of colonoscopy

Emara,

Mazid,

Elshaer

et al. 2024

World J Gastroenterol

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“…Acute kidney injury (AKI) is a severe clinical syndrome reported in patients undergoing endoscopic procedures such as colonoscopy [ 4 ] or endoscopy of the upper gastrointestinal tract for variceal [ 5 ] and nonvariceal bleeding [ 6 , 7 ]. Moreover, AKI occurs early after endoscopy and is associated with longer hospital stays, increased costs, and both short- and long-term mortality [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study

et al. 2022

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) represents a major pivotal point in gastrointestinal endoscopy. Little is known about acute kidney injury (AKI) post-ERCP. This study analyses the incidence, risk factors, and prognosis of post-ERCP AKI. Methods: A total of 396 patients were prospectively studied. AKI was defined by an increase in serum creatinine (SCr) ≥ 0.3 mg/dL or by an increase in SCr ≥ 50% in the first 48 h post-ERCP. Logistic regression analysis was used to identify the predictors of AKI and in-hospital mortality. A two-tailed p value < 0.05 was considered significant. Results: One hundred and three patients (26%) developed post-ERCP AKI. Estimated glomerular filtration rate (adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.94–0.96, p < 0.001), nonrenal Charlson Comorbidity Index (Aor = 1.19, 95% CI: 1.05–1.35, p = 0.006), choledocholithiasis (aOR = 4.05, 95% CI: 1.98–8.29, p < 0.001), and bilirubin (aOR = 1.1, 95% CI: 1.05–1.15, p < 0.001) were associated with post-ERCP AKI. Post-ERCP AKI was associated with longer hospital stay (p < 0.001) and with increased in-hospital mortality (7.76% versus 0.36%, p < 0.001). Moderate-to-severe (stage 2 and 3) AKI was independently associated with in-hospital mortality (aOR = 6.43, 95% CI: 1.48–27.88, p < 0.013). Conclusions: Post-ERCP AKI represented an important complication associated with longer hospital stay. Moderate-to-severe post-ERCP AKI was an independent risk factor for in-hospital mortality.

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“…4,5 However, OSP had resulted hyperphosphatemia, electrolyte imbalance and acute kidney injury (AKI) due to acute phosphate nephropathy both in patients with normal kidney function and chronic kidney disease. 6 Transient hyperphosphatemia leads to an increased intratubular phosphate concentration resulting in the precipitation and tissue deposition of calcium phosphate salts that cause luminal obstruction, direct tubular epithelial injury and activation of the immune response. 7,8 Volume depletion from OSP-induced osmotic diarrhea in the setting of reduced oral intake prior to the procedure further worsened the intraluminal calcium phosphate deposition.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of AKI after colonoscopy using different bowel cleansing agents ranged from 0.3 % to 41.2%. 6,11 According to KDIGO 2012 (Kidney Disease Improving Global Outcome), AKI is defined as any of the following: an increase in Serum Creatinine (S.Cr) by 0.3 mg/dl within 48 hours; or an increase in S Cr to 1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or Urine volume<0.5ml/kg/h for 6 hours. 12 More recently, PEG-based preparation are being used.…”

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Injury in Patients Using Polyethylene Glycol as Bowel Cleansing Agent for Colonoscopy

et al. 2022

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Introduction: The use of polyethylene glycol-based solutions is the gold standard for bowel preparation for colonoscopy. However, polyethylene glycol use might be associated with the risk of acute kidney injury. We aim to find out acute kidney injury and risk factors associated with the development of acute kidney injury in patients using polyethylene glycol for colonoscopy.Materials and Methods: This was an observational study conducted in the Department of Nephrology and Gastroenterology, Bir hospital. Patients who underwent colonoscopy using polyethylene glycol were included in the study and assessed for acute kidney injury; its incidence, association of risk factors with acute kidney injury, and outcome (complete recovery or no recovery) of acute kidney injury by 3 months.Results: The mean age of the patients was 45.81 ± 18.60 years with the majority of the patients being male (60%). Out of 48 study participants, 4(8%) develop acute kidney injury. Multivariate regression analysis depicted that chronic kidney disease, chronic liver disease, congestive cardiac failure, and use of non-steroidal anti-inflammatory drugs, angiotensin receptor blockers, and diuretics drugs were the predictors which significantly influenced the occurrence of acute kidney injury in patients using polyethylene glycol.Conclusions: The evidence strongly suggests that in patients without preexisting renal disease, comorbidities, or use of drugs; the risk of renal impairment is low after colonoscopy using polyethylene glycol as a bowel cleansing agent. In the presence of risk factors for renal dysfunction, polyethylene glycol should be used cautiously.

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Kidney injury and other complications related to colonoscopy in inpatients at a tertiary teaching hospital

Cited by 4 publications

References 18 publications

Trauma to the solid abdominal organs: The missed dark box of colonoscopy

Trauma to the solid abdominal organs: The missed dark box of colonoscopy

Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study

Acute Kidney Injury in Patients Using Polyethylene Glycol as Bowel Cleansing Agent for Colonoscopy

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