Citation

Hoffmanová I, Kraml P, Anděl M. Expert Opin. Drug Saf. 2015; 14(7): 1097-1110.

Affiliation

Charles University in Prague, 2nd Department of Internal Medicine, Third Faculty of Medicine , Ruská 87, 100 00 Prague 10 , Czech Republic +420 723 705 493, +420 267 162 703 ; iva.hoffmanova@fnkv.cz.

Copyright

(Copyright © 2015, Informa Healthcare)

DOI

10.1517/14740338.2015.1044970

PMID

26084636

Abstract

INTRODUCTION: Sodium phosphate purgatives are used for bowel preparation before endoscopic or radiologic examination and occasionally for treatment of severe obstipation. Generally, they are well tolerated and effective; however, safety concerns exist regarding serious renal injury and electrolyte disturbances after administration of these drugs. AREAS COVERED: The review presents complications associated with the use of agents containing sodium phosphate with regard to electrolyte disorders and renal impairment, namely acute phosphate nephropathy (APhN). This paper discusses the pathophysiology, histopathological findings, clinical symptoms, diagnosis and treatment of APhN. Additionally, it examines the epidemiology of adverse renal events and the safety of using sodium phosphate preparations prior to colonoscopy. EXPERT OPINION: Because of safety concerns, sodium phosphate purgatives are not recommended for routine bowel cleansing. Despite some serious and even fatal adverse events associated with these drugs when used with at-risk patients, available data suggest that administration of sodium phosphate purgatives is relatively safe in nonrisk individuals(i.e., in adequately hydrated, otherwise healthy adults, younger than 55 years with evidence of normal renal function).

Language: en