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104 ORAL SODIUM PHOSPHATE BEFORE COLONOSCOPY DOES NOT PREDICT THE DEVELOPMENT OF CHRONIC RENAL FAILURE R Abaskharoun, K Arunasalam, W Depew, S Vanner Oral sodium phosphate (NaP) for colon cleansing before colonoscopy is better tolerated and is as good as or better than oral polyethylene glycol (PEG) solutions. Accordingly, its use has become widespread. Isolated case reports of renal failure resulting from NaP use have been described as well as suggestions that this complication is more common than appreciated and can remain undetected. We tested the hypothesis that NaP ingestion before colonoscopy is associated with renal failure.
GI Diseases Research Unit, Queen's University, Kingston, Ontario
METHODS: Serum creatinine (Cr) and body weight were routinely measured before colonoscopy in our unit from 1995 to 2004. We identified a cohort of consecutive patients from our database who had serum creatinine drawn before colonoscopy and at least 30 days after their procedure. Development of chronic renal failure (CRF) was defined by an abnormal creatinine clearance as measured by the Cockroft-Gault equation at the time of repeat Cr measurement. CRF was also defined as development of an abnormal Cr at repeat measurement.
RESULTS: Seven hundred seventy patients (51%F, 49%M; 81% NaP, 19% PEG) with normal baseline Cr were identified through our database. Of these, 55 (7%) developed CRF after colonoscopy. Forty-two patients (7%) receiving NaP vs 13 patients (9%) receiving PEG developed renal failure (Fisher's exact test; P=0.382). Using logistic regression analysis with the choice of preparation, medications and medical comorbid conditions as dependant variables; only age and blood pressure were predictive of the development of renal failure (P=0.014 and P=0.001, respectively). Baseline creatinine clearance was similar in both the NaP and PEG groups. The absolute difference in creatinine clearance from baseline and after colonoscopy between the NaP and PEG groups was minimal and not significant (+0.89 mL/min vs -1.77 mL/min, respectively; P=0.111).
CONCLUSIONS: The prevalence of the development of renal failure between the NaP and PEG groups in this cohort of patients was similar (7% vs 9%, respectively). Predictors of renal failure were age and blood pressure independent of the preparation used. The absolute difference of the change in creatinine clearance was not significantly different between the NaP and PEG groups in this patient cohort.
Supported by an unrestricted educational grant from CB FLEET