Editorial
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World J Gastrointest Pharmacol Ther. May 6, 2014; 5(2): 50-54
Published online May 6, 2014. doi: 10.4292/wjgpt.v5.i2.50
Colonoscopy preparation-induced disorders in renal function and electrolytes
Matilda Florentin, George Liamis, Moses S Elisaf
Matilda Florentin, George Liamis, Moses S Elisaf, Department of Internal Medicine, School of Medicine, University of Ioannina, 45110 Ioannina, Greece
Author contributions: All the authors contributed to this manuscript.
Correspondence to: Moses S Elisaf, MD, FASA, FRSH, Professor of Internal Medicine, Department of Internal Medicine, School of Medicine, University of Ioannina, Ipiros, 45110 Ioannina, Greece. egepi@cc.uoi.gr
Telephone: +30-26510-07509  Fax: +30-26510-07016
Received: November 18, 2013
Revised: February 19, 2014
Accepted: April 16, 2014
Published online: May 6, 2014
Processing time: 186 Days and 11.8 Hours
Abstract

Colonoscopy and flexible sigmoidoscopy are commonly used mainly for colon cancer screening and detection, but also in several other situations such as inflammatory bowel disease (for diagnosis and follow up) and gastrointestinal hemorrhage. Bowel cleansing preparations mainly include polyethylene glycol and oral sodium phosphate solutions, with the later being most frequently used due to better toleration from patients. Despite their favourable safety profile these agents have been associated with renal function deterioration and electrolyte disorders, some of which were serious or even fatal. The present paper discusses the complications associated with colonoscopy preparation agents.

Keywords: Oral sodium phosphate; Hyperphosphatemia; Hypocalcemia; Phosphate nephropathy

Core tip: Despite the important diagnostic and clinical utility of colonoscopy, serious electrolyte disorders and impaired kidney function have been observed with the agents used for bowel cleansing. The aim of this paper is to present these complications and discuss their prevention and management.

Colonoscopy is widely used worldwide particularly for colon cancer screening and detection. The use of bowel cleansing agents one or two days prior the procedure improves its diagnostic utility. Various preparations have been developed throughout the years, but few of them are currently being used, specifically polyethylene glycol and oral sodium phosphate (OSP) solutions, because of their ease of use and safety profile[1]. As minimal volume of oral intake is required with OSP, this is associated with less patient discomfort, greater compliance and improved colonic cleansing compared with polyethylene glycol[2]. However, serious electrolyte disorders and impaired kidney function have been observed with these agents and particularly with OSP. The aim of this paper is to present these complications and discuss their prevention and management. Disturbances in electrolyte levels with less frequently used bowel cleansing agents are also mentioned.