Hyperphosphatemia after sodium phosphate laxatives in low risk patients: Prospective study

Casais, Marcela Noemi; Rosa-Diez, Guillermo; Pérez, Susana; Mansilla, Elina Noemi; Bravo, Susana; Bonofiglio, Francisco Carlos; Karabacakoglu, Aydin; Biondi, Alberto
December 2009
World Journal of Gastroenterology;12/21/2009, Vol. 15 Issue 47, p5960
Academic Journal
AIM: To establish the frequency of hyperphosphatemia following the administration of sodium phosphate laxatives in low-risk patients. METHODS: One hundred consecutive ASA I-II individuals aged 35-74 years, who were undergoing colonic cleansing with oral sodium phosphate (OSP) before colonoscopy were recruited for this prospective study. Exclusion criteria: congestive heart failure, chronic kidney disease, diabetes, liver cirrhosis, intestinal obstruction, decreased bowel motility, increased bowel permeability, and hyperparathyroidism. The day before colonoscopy, all the participants entered a 24-h period of diet that consisted of 4 L of clear fluids with sugar or honey and 90 mL (60 g) of OSP in two 45-mL doses, 4 h apart. Serum phosphate was measured before and after the administration of the laxative. RESULTS: The main demographic data (mean ± SD) were: age, 58.9 ± 8.4 years; height, 163.8 ±8.6 cm; weight, 71 ± 13 kg; body mass index, 26 ± 4; women, 66%. Serum phosphate increased from 3.74 ± 0.56 to 5.58 ± 1.1 mg/dL, which surpassed the normal value (2.5-4.5 mg/dL) in 87% of the patients. The highest serum phosphate was 9.6 mg/dL. Urea and creatinine remained within normal limits. Post-treatment OSP serum phosphate concentration correlated inversely with glomerular filtration rate (P < 0.007, R² = 0.0755), total body water (P < 0.001, R² = 0.156) and weight (P < 0.013, R² = 0.0635). CONCLUSION: In low-risk, well-hydrated patients, the standard dose of OSP-laxative-induced hyperphosphatemia is related to body weight.


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