Acute Kidney Injury Not Increased By Oral Sodium Phosphate
No increased risk of acute kidney injury with OSP versus polyethylene glycol.
Use of oral sodium phosphate (OSP) for bowel cleansing prior to a colonoscopy is not associated with the risk of postprocedure acute kidney injury (AKI), according to a study published in Clinical Gastroenterology and Hepatology.
J. Bradley Layton, Ph.D., from the University of North Carolina at Chapel Hill, and colleagues utilized an insurance database to identify a cohort of patients (aged 50 to 75 years) who underwent screening colonoscopies as outpatients from January 2000 through November 2008 (before the U.S. Food and Drug Administration warning against OSP use).
The cohort included 121,266 patients who received OSP and 429,430 who received polyethylene glycol (PEG) within 30 days before the procedure, without prior use of either drug. Data were obtained from six months afterward to identify those who developed AKI or renal failure, or received dialysis.
The researchers found that AKI occurred in 0.2 percent of OSP users and in 0.3 percent of PEG users (adjusted hazard ratio, 0.86; 95 percent confidence interval, 0.75 to 0.99). OSP users and PEG users were well matched, producing similar estimates (hazard ratio, 0.85; 95 percent confidence interval, 0.72 to 1.01). In subgroup analysis there was no consistent increase in the risk of AKI or other outcomes.
"In a large database analysis, we did not associate administration of OSP before colonoscopy with increased risk of postprocedure AKI, even in high-risk clinical subgroups," the authors write.
One author disclosed financial ties to the pharmaceutical industry.