Risk of Kidney Injury Following Oral Phosphosoda Bowel Preparations

Abstract

Case reports and case series suggest a potential link between oral sodium phosphosoda used in preparation for outpatient colonoscopy and kidney injury, but controlled studies are lacking. We performed a case-control study nested within a cohort of patients with baseline serum creatinine Յ1.5 mg/dL who underwent outpatient colonoscopy. We defined a case of kidney injury as a rise in serum creatinine Ն0.5 mg/dL and/or 25% between values obtained during the 6 months prior and during the 6 months following colonoscopy (n ϭ 116). We found that exposure to phosphosoda was not more common among patients with incident kidney injury (adjusted odds ratio 0.70; 95% CI 0.44 -1.11), and sensitivity analyses that considered other definitions of kidney injury did not suggest a different conclusion. Therefore, despite a plausible link, the current data do not support an association between oral phosphosoda and kidney injury at 6 months follow-up among patients with baseline serum creatinine Յ1.5 mg/dL. Further studies are warranted to validate and generalize our findings.

A Murine Model of Phosphate Nephropathy

“…16 Most of our present information on phosphate nephropathy derives from case series and retrospective epidemiologic analyses. 11,14,[17][18][19] Moreover, there is no specific therapy for established phosphate nephropathy.…”

Findings of Biopsy-Proven Chronicity and End-Stage Renal Failure Associated with Oral Sodium Phosphate Solution

“…But it has the potential for acute kidney injury called APN. 1 The incidence of APN remains unknown and it can occur even with normal renal function.…”

Randomised clinical trial: MiraLAX vs. Golytely – a controlled study of efficacy and patient tolerability in bowel preparation for colonoscopy

“…9,10 The literature also confirms that patients prefer lower volume solutions related to their being more comfortable and tolerable. 7,11 With the issue of FDA regulatory warnings on the use of Fleets Phospho-soda in bowel preparation, [12][13][14] interest has increasingly shifted to the use of MiraLAX (polyethylene glycol 3350 powder) in combination with Gatorade as an alternative to well-established polyethylene glycol solutions such as Golytely (4 L PEG 3350 electrolyte solution) MiraLAX is FDA approved for constipation and has also been studied in paediatric chronic constipation. [15][16][17] A small, single-arm community-based study of 29 patients who underwent colonoscopy with a MiraLAX ⁄ Gatorade preparation reported that it was efficacious, safe and well tolerated by patients.…”