title: The renal safety of bowel preparations for colonoscopy: a comparative study of oral sodium phosphate solution and polyethylene glycol.
abstract: BACKGROUND
  Rare cases of nephrotoxicity have been reported with oral sodium phosphate solution (OSPS).
  
  
  OBJECTIVE
  To evaluate whether OSPS is associated with changes in renal function.
  
  
  METHODS
  A chart review performed on 311 patients who had colonoscopy at the James J. Peters VA Medical Centre prepared with either OSPS (n = 157) or polyethylene glycol (PEG) (n = 154). Patients had a baseline serum creatinine <or=1.5 mg/dL. Effect of bowel preparation on the renal function was evaluated by measuring the absolute change in levels of serum creatinine and the proportion of patients who developed a 50% or more increase above their baseline serum creatinine value.
  
  
  RESULTS
  Oral sodium phosphate solution resulted in a slight increase in serum creatinine from 1.0 +/- 0.02 to 1.1 +/- 0.02 mg/dL (P = 0.07) and PEG resulted in a small decrease in serum creatinine from 1.1 +/- 0.02 to 1.0 +/- 0.03 mg/dL (P = 0.03). The absolute change in serum creatinine was slightly higher with OSPS than with PEG (0.04 +/- 0.02 vs. -0.05 +/- 0.02 mg/dL; P = 0.005). However, the proportion of patients who had a >or=50% increase above their baseline creatinine was similar (OSPS vs. PEG, 5% vs. 3%, P = 0.77).
  
  
  CONCLUSIONS
  Oral sodium phosphate solution was associated with a slight increase in serum creatinine, which was not clinically significant. Renal toxicity from OSPS appears to be minimal when used in patients with serum creatinine value <1.5 mg/dL.
authors.affiliation: Department of Medicine, James J. Peters VA Medical Center, Bronx, NY 10468, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Singal
authors.forename: A S
authors.initials: AS
authors.lastname: Rosman
authors.forename: J B
authors.initials: JB
authors.lastname: Post
authors.forename: W A
authors.initials: WA
authors.lastname: Bauman
authors.forename: A M
authors.initials: AM
authors.lastname: Spungen
authors.forename: M A
authors.initials: MA
authors.lastname: Korsten
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000368:Aged; D002400:Cathartics / Q000009:adverse effects*; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000008:administration & dosage / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000009:adverse effects*; D012044:Regression Analysis; D012189:Retrospective Studies; D007507:Therapeutic Irrigation
chemical_list: D002400:Cathartics; D010710:Phosphates; D011092:Polyethylene Glycols; D003404:Creatinine; C018279:sodium phosphate