title: Polyethylene glycol bowel preparation does not eliminate the risk of acute renal failure: a population-based case-crossover study.
abstract: OBJECTIVE
  Polyethylene glycol (PEG) bowel preparations are regarded as effective and safe for colonoscopy; however, recent reports have indicated a risk of acute renal failure (ARF). This population-based case-crossover study evaluated the association between PEG and ARF in screening colonoscopy patients aged ≥ 50 years.
  
  
  METHODS
  Korean Health Insurance Review and Assessment Service (HIRA) claims data from 1 January 2005 to 31 December 2009 were used in the study. The study population consisted of patients aged ≥ 50 years who were first hospitalized for ARF following colonoscopy involving PEG bowel preparation. For each patient, PEG use in a 1-, 2-, or 4-week period prior to the first hospital admission date for ARF (hazard period) was compared with PEG use in four earlier 1-, 2-, or 4-week control periods. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs), adjusting for concomitant medications that could induce ARF.
  
  
  RESULTS
  The total number of study patients was 1064 (59 % were male). A greater proportion of patients used PEG during the hazard period than during the control periods (for 4-week time window: 8.8 % vs. 3.2 %). The adjusted ORs for ARF incidence when applying the 1-, 2-, and 4-week periods were 3.1 (95 %CI 2.06 - 4.73), 2.5 (95 %CI 1.76 - 3.53), and 2.1 (95 %CI 1.61 - 4.85), respectively.
  
  
  CONCLUSIONS
  The use of PEG was associated with the risk of ARF. Adequate hydration and renal function monitoring should be assured before and after colonoscopy, regardless of the bowel preparation regimen used.
authors: Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, South Korea.
authors: N K
authors: NK
authors: Choi
authors: J
authors: J
authors: Lee
authors: Y
authors: Y
authors: Chang
authors: S Y
authors: SY
authors: Jung
authors: Y J
authors: YJ
authors: Kim
authors: S M
authors: SM
authors: Lee
authors: J H
authors: JH
authors: Lee
authors: J Y
authors: JY
authors: Kim
authors: H J
authors: HJ
authors: Song
authors: B J
authors: BJ
authors: Park
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects*; D003113:Colonoscopy; D016001:Confidence Intervals; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols