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

Nam-Kyong Choi; Joongyub Lee; Yoosoo Chang; Ye-Jee Kim; Ju-Young Kim; Hong Ji Song; Ju-Young Shin; Sun-Young Jung; Yukyong Choi; Jin-Ho Lee; Byung-Joo Park

doi:10.1055/s-0034-1365419

Endoscopy, Table of Contents

Endoscopy 2014; 46(06): 465-470
DOI: 10.1055/s-0034-1365419

Original article

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

Authors

Nam-Kyong Choi^*

¹Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, Korea

²Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
Joongyub Lee^*

¹Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, Korea
Yoosoo Chang

³Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
Ye-Jee Kim

⁴Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
Ju-Young Kim

⁵Department of Family Medicine, Health Promotion Center, Seoul National University Bundang Hospital, Bundang, Korea
Hong Ji Song

⁶Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
Ju-Young Shin

⁷Korea Institute of Drug Safety and Risk Management, Seoul, Korea
Sun-Young Jung

⁷Korea Institute of Drug Safety and Risk Management, Seoul, Korea
Yukyong Choi

⁸Department of Internal Medicine, Hyewon St. Mary’s Hospital, Gumi, Korea
Jin-Ho Lee

⁹Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
Byung-Joo Park

¹Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, Korea

⁴Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea

⁷Korea Institute of Drug Safety and Risk Management, Seoul, Korea

Abstract

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.

Full Text

References

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