The Columbia College of Physicians and Surgeons has recently reported 21 cases of acute kidney failure from some of the bowel-cleansing preparations some of which are sold over-the-counter for use on the night prior to colonoscopy.
In an article on December 27, 2005, the New York Times reports that the Columbia College of Physicians and Surgeons has recently reported 21 cases of acute kidney failure from some of the bowel-cleansing preparations some of which are sold over-the-counter for use on the night prior to colonoscopy. Specifically at issue are those products containing sodium phosphate; these include Visicol Tablets (sold by prescription); and Fleet-Phosphosoda and other store-brand versions of the product containing the same active ingredients. The kidney failure reported by the Columbia physicians includes three cases that led to the patient requiring permanent dialysis, and one case resulting in a kidney transplant. The entire report appears in the November issue of the Journal of the American Society of Nephrology.
It was previously believed that only those patients with impaired kidneys or congestive heart failure were particularly vulnerable to kidney damage from sodium phosphate products; the current study now broadens the list of persons who may be vulnerable to include healthy elderly people, patients with unstable angina or who have had hearta attacks and anyone who is particularly likely to become dehydrated (this includes persons taking certain medications for hypertension and people who do not drink enough fluid to replenish that lost in bowel cleansing).
The Times article reports that the kidney damage has only been noted in those persons who used these products as a bowel preparation; no kidney damage has been reported in cases where the medications were prescribed in much smaller doses for use as a laxative. C.B. Fleet of Lynchburg, Virginia, the manufacturer of Fleet-Phosphosoda, has posted updated guidelines on its web site and sent letters to physicians warning of this risk.
Other commonly used bowel preparations such as “GoLytely” and “Colyte” are phosphate free and are not known to pose a risk of kidney damage.