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Polyethylene glycol bowel preparation does not eliminate the risk of acute renal failure: a population-based case-crossover study.
Endoscopy. 2013; 45(3):208-13.E

Abstract

BACKGROUND AND STUDY AIMS

Polyethylene glycol (PEG) bowel preparations are regarded as effective and safe for colonoscopy; however, recent reports have indicated a risk of acute renal failure (ARF). This population-based case-crossover study evaluated the association between PEG and ARF in screening colonoscopy patients aged ≥ 50 years.

PATIENTS AND METHODS

Korean Health Insurance Review and Assessment Service (HIRA) claims data from 1 January 2005 to 31 December 2009 were used in the study. The study population consisted of patients aged ≥ 50 years who were first hospitalized for ARF following colonoscopy involving PEG bowel preparation. For each patient, PEG use in a 1-, 2-, or 4-week period prior to the first hospital admission date for ARF (hazard period) was compared with PEG use in four earlier 1-, 2-, or 4-week control periods. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs), adjusting for concomitant medications that could induce ARF.

RESULTS

The total number of study patients was 1064 (59 % were male). A greater proportion of patients used PEG during the hazard period than during the control periods (for 4-week time window: 8.8 % vs. 3.2 %). The adjusted ORs for ARF incidence when applying the 1-, 2-, and 4-week periods were 3.1 (95 %CI 2.06 - 4.73), 2.5 (95 %CI 1.76 - 3.53), and 2.1 (95 %CI 1.61 - 4.85), respectively.

CONCLUSIONS

The use of PEG was associated with the risk of ARF. Adequate hydration and renal function monitoring should be assured before and after colonoscopy, regardless of the bowel preparation regimen used.

Authors+Show Affiliations

Medical Research Collaborating Center, Seoul National University Hospital/Seoul National University College of Medicine, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23322476

Citation

Choi, N K., et al. "Polyethylene Glycol Bowel Preparation Does Not Eliminate the Risk of Acute Renal Failure: a Population-based Case-crossover Study." Endoscopy, vol. 45, no. 3, 2013, pp. 208-13.
Choi NK, Lee J, Chang Y, et al. Polyethylene glycol bowel preparation does not eliminate the risk of acute renal failure: a population-based case-crossover study. Endoscopy. 2013;45(3):208-13.
Choi, N. K., Lee, J., Chang, Y., Jung, S. Y., Kim, Y. J., Lee, S. M., Lee, J. H., Kim, J. Y., Song, H. J., & Park, B. J. (2013). Polyethylene glycol bowel preparation does not eliminate the risk of acute renal failure: a population-based case-crossover study. Endoscopy, 45(3), 208-13. https://doi.org/10.1055/s-0032-1326031
Choi NK, et al. Polyethylene Glycol Bowel Preparation Does Not Eliminate the Risk of Acute Renal Failure: a Population-based Case-crossover Study. Endoscopy. 2013;45(3):208-13. PubMed PMID: 23322476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polyethylene glycol bowel preparation does not eliminate the risk of acute renal failure: a population-based case-crossover study. AU - Choi,N K, AU - Lee,J, AU - Chang,Y, AU - Jung,S Y, AU - Kim,Y J, AU - Lee,S M, AU - Lee,J H, AU - Kim,J Y, AU - Song,H J, AU - Park,B J, Y1 - 2013/01/15/ PY - 2013/1/17/entrez PY - 2013/1/17/pubmed PY - 2013/10/1/medline SP - 208 EP - 13 JF - Endoscopy JO - Endoscopy VL - 45 IS - 3 N2 - BACKGROUND AND STUDY AIMS: Polyethylene glycol (PEG) bowel preparations are regarded as effective and safe for colonoscopy; however, recent reports have indicated a risk of acute renal failure (ARF). This population-based case-crossover study evaluated the association between PEG and ARF in screening colonoscopy patients aged ≥ 50 years. PATIENTS AND METHODS: Korean Health Insurance Review and Assessment Service (HIRA) claims data from 1 January 2005 to 31 December 2009 were used in the study. The study population consisted of patients aged ≥ 50 years who were first hospitalized for ARF following colonoscopy involving PEG bowel preparation. For each patient, PEG use in a 1-, 2-, or 4-week period prior to the first hospital admission date for ARF (hazard period) was compared with PEG use in four earlier 1-, 2-, or 4-week control periods. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs), adjusting for concomitant medications that could induce ARF. RESULTS: The total number of study patients was 1064 (59 % were male). A greater proportion of patients used PEG during the hazard period than during the control periods (for 4-week time window: 8.8 % vs. 3.2 %). The adjusted ORs for ARF incidence when applying the 1-, 2-, and 4-week periods were 3.1 (95 %CI 2.06 - 4.73), 2.5 (95 %CI 1.76 - 3.53), and 2.1 (95 %CI 1.61 - 4.85), respectively. CONCLUSIONS: The use of PEG was associated with the risk of ARF. Adequate hydration and renal function monitoring should be assured before and after colonoscopy, regardless of the bowel preparation regimen used. SN - 1438-8812 UR - https://www.unboundmedicine.com/medline/citation/23322476/Polyethylene_glycol_bowel_preparation_does_not_eliminate_the_risk_of_acute_renal_failure:_a_population_based_case_crossover_study_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0032-1326031 DB - PRIME DP - Unbound Medicine ER -