Risk of Renal Injury after the Use of Polyethylene Glycol for Outpatient Colonoscopy: A Prospective Observational Study

Chi Liang Cheng, Nai Jen Liu, Jui-Hsiang Tang, Yen Lin Kuo, Cheng Hui Lin, Jau Min Lien, Yi Ning Tsui, Bai Ping Lee, Hsiang Ling Hung

Research output: Contribution to journalArticle

Abstract

Goal: The goal of this study was to estimate the risk of renal injury after the use of 3-L polyethylene glycol (PEG) before outpatient colonoscopy. Background: Population-based studies showed that the use of PEG was associated with renal injury, but this association has not been confirmed by prospective study. Study: Patients ≥40 years of age with an estimated glomerular filtration rate ≥30 mL/min were screened for enrollment. Laboratory data were collected before, during, and after the colonoscopies. Patients with a ≥30% increase in baseline serum creatinine levels were followed until a peak level was detected. Renal injury included acute renal dysfunction (ARD) and acute kidney injury (AKI), defined as a 30% to 49% increase and ≥50% increase in creatinine levels compared with the baseline, respectively. Results: A total of 1163 patients (mean age, 55.7 y) completed the study. Baseline and first postcolonoscopy laboratory data were obtained an average of 17.0 days before and 17.3 days after the colonoscopies were performed, respectively. Renal injury was identified in 32 patients; 26 patients (2.2%) had ARD, and 6 patients (0.5%) had AKI. All patients with renal injury recovered fully during follow-up. In the subgroup analysis, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) before colonoscopy was statistically associated with the development of AKI (odds ratio, 6.5; 95% confidence interval, 1.2-35.5; P=0.03). Conclusions: This prospective study showed that the use of PEG was associated with a small risk of renal injury. NSAIDs use was statistically associated with AKI in the context of colonoscopy for which PEG was used for bowel preparation.

Original languageEnglish
JournalJournal of Clinical Gastroenterology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Colonoscopy
Observational Studies
Acute Kidney Injury
Outpatients
Prospective Studies
Kidney
Wounds and Injuries
Creatinine
Anti-Inflammatory Agents
Glomerular Filtration Rate
Pharmaceutical Preparations
Odds Ratio
Confidence Intervals
Serum
Population

Keywords

  • bowel preparation
  • colonoscopy
  • polyethylene glycol
  • renal injury

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Risk of Renal Injury after the Use of Polyethylene Glycol for Outpatient Colonoscopy : A Prospective Observational Study. / Cheng, Chi Liang; Liu, Nai Jen; Tang, Jui-Hsiang; Kuo, Yen Lin; Lin, Cheng Hui; Lien, Jau Min; Tsui, Yi Ning; Lee, Bai Ping; Hung, Hsiang Ling.

In: Journal of Clinical Gastroenterology, 01.01.2018.

Research output: Contribution to journalArticle

Cheng, Chi Liang ; Liu, Nai Jen ; Tang, Jui-Hsiang ; Kuo, Yen Lin ; Lin, Cheng Hui ; Lien, Jau Min ; Tsui, Yi Ning ; Lee, Bai Ping ; Hung, Hsiang Ling. / Risk of Renal Injury after the Use of Polyethylene Glycol for Outpatient Colonoscopy : A Prospective Observational Study. In: Journal of Clinical Gastroenterology. 2018.
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abstract = "Goal: The goal of this study was to estimate the risk of renal injury after the use of 3-L polyethylene glycol (PEG) before outpatient colonoscopy. Background: Population-based studies showed that the use of PEG was associated with renal injury, but this association has not been confirmed by prospective study. Study: Patients ≥40 years of age with an estimated glomerular filtration rate ≥30 mL/min were screened for enrollment. Laboratory data were collected before, during, and after the colonoscopies. Patients with a ≥30{\%} increase in baseline serum creatinine levels were followed until a peak level was detected. Renal injury included acute renal dysfunction (ARD) and acute kidney injury (AKI), defined as a 30{\%} to 49{\%} increase and ≥50{\%} increase in creatinine levels compared with the baseline, respectively. Results: A total of 1163 patients (mean age, 55.7 y) completed the study. Baseline and first postcolonoscopy laboratory data were obtained an average of 17.0 days before and 17.3 days after the colonoscopies were performed, respectively. Renal injury was identified in 32 patients; 26 patients (2.2{\%}) had ARD, and 6 patients (0.5{\%}) had AKI. All patients with renal injury recovered fully during follow-up. In the subgroup analysis, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) before colonoscopy was statistically associated with the development of AKI (odds ratio, 6.5; 95{\%} confidence interval, 1.2-35.5; P=0.03). Conclusions: This prospective study showed that the use of PEG was associated with a small risk of renal injury. NSAIDs use was statistically associated with AKI in the context of colonoscopy for which PEG was used for bowel preparation.",
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T1 - Risk of Renal Injury after the Use of Polyethylene Glycol for Outpatient Colonoscopy

T2 - A Prospective Observational Study

AU - Cheng, Chi Liang

AU - Liu, Nai Jen

AU - Tang, Jui-Hsiang

AU - Kuo, Yen Lin

AU - Lin, Cheng Hui

AU - Lien, Jau Min

AU - Tsui, Yi Ning

AU - Lee, Bai Ping

AU - Hung, Hsiang Ling

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Y1 - 2018/1/1

N2 - Goal: The goal of this study was to estimate the risk of renal injury after the use of 3-L polyethylene glycol (PEG) before outpatient colonoscopy. Background: Population-based studies showed that the use of PEG was associated with renal injury, but this association has not been confirmed by prospective study. Study: Patients ≥40 years of age with an estimated glomerular filtration rate ≥30 mL/min were screened for enrollment. Laboratory data were collected before, during, and after the colonoscopies. Patients with a ≥30% increase in baseline serum creatinine levels were followed until a peak level was detected. Renal injury included acute renal dysfunction (ARD) and acute kidney injury (AKI), defined as a 30% to 49% increase and ≥50% increase in creatinine levels compared with the baseline, respectively. Results: A total of 1163 patients (mean age, 55.7 y) completed the study. Baseline and first postcolonoscopy laboratory data were obtained an average of 17.0 days before and 17.3 days after the colonoscopies were performed, respectively. Renal injury was identified in 32 patients; 26 patients (2.2%) had ARD, and 6 patients (0.5%) had AKI. All patients with renal injury recovered fully during follow-up. In the subgroup analysis, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) before colonoscopy was statistically associated with the development of AKI (odds ratio, 6.5; 95% confidence interval, 1.2-35.5; P=0.03). Conclusions: This prospective study showed that the use of PEG was associated with a small risk of renal injury. NSAIDs use was statistically associated with AKI in the context of colonoscopy for which PEG was used for bowel preparation.

AB - Goal: The goal of this study was to estimate the risk of renal injury after the use of 3-L polyethylene glycol (PEG) before outpatient colonoscopy. Background: Population-based studies showed that the use of PEG was associated with renal injury, but this association has not been confirmed by prospective study. Study: Patients ≥40 years of age with an estimated glomerular filtration rate ≥30 mL/min were screened for enrollment. Laboratory data were collected before, during, and after the colonoscopies. Patients with a ≥30% increase in baseline serum creatinine levels were followed until a peak level was detected. Renal injury included acute renal dysfunction (ARD) and acute kidney injury (AKI), defined as a 30% to 49% increase and ≥50% increase in creatinine levels compared with the baseline, respectively. Results: A total of 1163 patients (mean age, 55.7 y) completed the study. Baseline and first postcolonoscopy laboratory data were obtained an average of 17.0 days before and 17.3 days after the colonoscopies were performed, respectively. Renal injury was identified in 32 patients; 26 patients (2.2%) had ARD, and 6 patients (0.5%) had AKI. All patients with renal injury recovered fully during follow-up. In the subgroup analysis, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) before colonoscopy was statistically associated with the development of AKI (odds ratio, 6.5; 95% confidence interval, 1.2-35.5; P=0.03). Conclusions: This prospective study showed that the use of PEG was associated with a small risk of renal injury. NSAIDs use was statistically associated with AKI in the context of colonoscopy for which PEG was used for bowel preparation.

KW - bowel preparation

KW - colonoscopy

KW - polyethylene glycol

KW - renal injury

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