Endoscopy 2014; 46(06): 465-470
DOI: 10.1055/s-0034-1365419
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Acute renal failure following oral sodium phosphate bowel preparation: a nationwide case-crossover study

Nam-Kyong Choi*
1  Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, Korea
2  Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
,
Joongyub Lee*
1  Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, Korea
,
Yoosoo Chang
3  Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Ye-Jee Kim
4  Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
,
Ju-Young Kim
5  Department of Family Medicine, Health Promotion Center, Seoul National University Bundang Hospital, Bundang, Korea
,
Hong Ji Song
6  Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
,
Ju-Young Shin
7  Korea Institute of Drug Safety and Risk Management, Seoul, Korea
,
Sun-Young Jung
7  Korea Institute of Drug Safety and Risk Management, Seoul, Korea
,
Yukyong Choi
8  Department of Internal Medicine, Hyewon St. Mary’s Hospital, Gumi, Korea
,
Jin-Ho Lee
9  Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
,
Byung-Joo Park
1  Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, Korea
4  Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
7  Korea Institute of Drug Safety and Risk Management, Seoul, Korea
› Author Affiliations
Further Information

Publication History

submitted 20 March 2013

accepted after revision 12 February 2014

Publication Date:
25 April 2014 (eFirst)

Background and study aims: Oral sodium phosphate (OSP) is a cleansing agent for colonoscopy. Recent reports have cited an increased risk of acute renal failure (ARF) in OSP bowel purgative users, but this risk remains under debate. This study was performed to evaluate the association between OSP and ARF in patients who underwent colonoscopy.

Patients and methods: A population-based case-crossover study was conducted using the Korean Health Insurance Review and Assessment Service (HIRA) claims data from 1 January 2005 to 31 December 2009. The study population consisted of patients aged ≥ 50 years who underwent colonoscopies after an OSP prescription prior to their first hospitalization for ARF. For each patient, one hazard and four control periods were matched at specified time windows. Conditional logistic regression analysis was used to estimate the odds ratio (OR) and 95 % confidence interval (CI), adjusting for concomitant medications that could induce ARF.

Results: A total of 1105 patients were included (54 % male). The adjusted ORs for ARF related to the use of OSP when applying the 1-, 2-, 4-, 8-, or 12-week time windows were 3.7 (95 %CI 2.37 – 5.67), 3.5 (95 %CI 2.45 – 4.89), 3.0 (95 %CI 2.30 – 3.95), 2.4 (95 %CI 1.93 – 2.96), and 2.0 (95 %CI 1.69 – 2.46), respectively. When adopting an 8-week time window, the adjusted OR was 2.5 (95 %CI 1.98 – 3.16) for the subgroup without chronic renal failure.

Conclusions: The use of OSP was significantly associated with ARF both in patients with and without co-morbidities.

* These authors contributed equally to this work.