Abstract

More and more case reports of acute kidney injury are published nowadays because of bowel cleansing with oral sodium phosphate before colonoscopy. Epidemiological studies disclose that the incidence of acute phosphate nephropathy in patients with normal or near-normal renal function could range from 1 to 4%. Without specific symptoms or signs, acute phosphate nephropathy cannot be easily recognized days or months after bowel cleansing with oral sodium phosphate before colonoscopy. The toxicity of oral sodium phosphate is related to its high phosphate content, which damages renal tubular epithelium by forming calcium phosphate crystal inside the epithelial cells, as nephrocalcinosis. In addition, oral sodium phosphate can cause electrolyte imbalance (hyperphosphatemia, hypocalcemia, hypernatremia, hypokalemia) that is sometimes catastrophically symptomatic. To prevent or lessen the toxicity of oral sodium phosphate, it is better to avoid such bowel preparation agents in the high-risk patients (old age, chronic kidney disease, hypertension receiving ACEI or ARB, and diabetes). Besides, modifying current standard regimen of oral sodium phosphate by reducing or postponing the second 45mL dose could also be with some help to reduce the toxicity of such a high phosphate load. Finally, after oral sodium phosphate bowel purgatives are used, it is advised to have patients' biochemistry and electrolyte exams in order to salvage their possibly deteriorating renal functions.

Original languageEnglish
Pages (from-to)425-433
Number of pages9
JournalJournal of Internal Medicine of Taiwan
Volume20
Issue number5
Publication statusPublished - 2009 Oct

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Phosphates
Colonoscopy
Kidney
Electrolytes
Cathartics
Nephrocalcinosis
Hypernatremia
Hyperphosphatemia
Hypokalemia
Hypocalcemia
sodium phosphate
Chronic Renal Insufficiency
Acute Kidney Injury
Biochemistry
Signs and Symptoms
Epidemiologic Studies
Epithelium
Epithelial Cells
Hypertension
Incidence

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

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title = "Acute phosphate nephropathy",
abstract = "More and more case reports of acute kidney injury are published nowadays because of bowel cleansing with oral sodium phosphate before colonoscopy. Epidemiological studies disclose that the incidence of acute phosphate nephropathy in patients with normal or near-normal renal function could range from 1 to 4{\%}. Without specific symptoms or signs, acute phosphate nephropathy cannot be easily recognized days or months after bowel cleansing with oral sodium phosphate before colonoscopy. The toxicity of oral sodium phosphate is related to its high phosphate content, which damages renal tubular epithelium by forming calcium phosphate crystal inside the epithelial cells, as nephrocalcinosis. In addition, oral sodium phosphate can cause electrolyte imbalance (hyperphosphatemia, hypocalcemia, hypernatremia, hypokalemia) that is sometimes catastrophically symptomatic. To prevent or lessen the toxicity of oral sodium phosphate, it is better to avoid such bowel preparation agents in the high-risk patients (old age, chronic kidney disease, hypertension receiving ACEI or ARB, and diabetes). Besides, modifying current standard regimen of oral sodium phosphate by reducing or postponing the second 45mL dose could also be with some help to reduce the toxicity of such a high phosphate load. Finally, after oral sodium phosphate bowel purgatives are used, it is advised to have patients' biochemistry and electrolyte exams in order to salvage their possibly deteriorating renal functions.",
author = "Te-Hui Kuo and Junne-Ming Sung and Chin-Chung Tseng and Cheng, {Meng Fu} and An-Bang Wu and Ming-Cheng Wang",
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Acute phosphate nephropathy. / Kuo, Te-Hui; Sung, Junne-Ming; Tseng, Chin-Chung; Cheng, Meng Fu; Wu, An-Bang; Wang, Ming-Cheng.

In: Journal of Internal Medicine of Taiwan, Vol. 20, No. 5, 10.2009, p. 425-433.

Research output: Contribution to journalArticle

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