Colonoscopy saves lives that might otherwise be claimed by colon cancer. But the preparation for colonoscopy may be dangerous, at least for older adults, people with diabetes, those taking certain blood pressure drugs, and people with kidney failure. That's the pretty surprising conclusion of researchers writing in the current issue of the Archives of Internal Medicine.
Colonoscopy is nearly useless unless the colon is clean. Sparkling. Oral sodium phosphate is the stuff given most often to people to take in advance of the procedure to empty the colon. But the findings of this new study suggest that sodium phosphate may cause acute kidney failure and chronic kidney disease that persists long after the test is over. Right now, kidney fitness for sodium phosphate is assessed by determining levels of serum creatinine. These investigators suggest that more sophisticated kidney function testing may be appropriate, at least among people in high-risk groups. They also recommend getting enough water to drink during this process and avoiding ACE inhibitors and ARBs (blood pressure drugs) if you're in a high-risk group for kidney problems. An alternative to sodium phosphate, polyethylene glycol, or PEG, may be a better option.
See also The Washington Post.