Published 17 July 2008, doi:10.1136/bmj.a182
Cite this as: BMJ 2008;337:a182

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Acute phosphate nephropathy after sodium phosphate preparations

Andrew Connor, registrar in renal medicine1, Lucy Sykes, senior house officer in renal medicine1, Ian S D Roberts, consultant histopathologist2, Charles E Weston, consultant nephrologist1

1 Department of Renal Medicine, Dorset County Hospital, Dorchester DT1 2JY, 2 Department of Cellular Pathology, John Radcliffe Hospital, Oxford OX3 9DU

Correspondence to: A Connor, 3 Hope Terrace, Martinstown, Dorset DT2 9JN andrewconnor1974@hotmail.co.uk

Predisposed individuals may develop chronic kidney disease after administration of sodium phosphate purgative before colonoscopy

The first 150 words of the full text of this article appear below.

Oral sodium phosphate preparations are used as bowel purgatives before colonoscopy. Subsequent renal impairment is increasingly being reported.1 We describe a case of acute phosphate nephropathy with persistent renal impairment after administration of sodium phosphate.

A 76 year old woman was admitted with rectal bleeding. Her past medical history included hypertension—treated with nifedipine—and long standing use of tobacco. Physical examination was unremarkable.

Laboratory results were normal—haemoglobin 106 g/l, white cell count 7.2x109/l, platelets 357x109/l, sodium 132 mmol/l, potassium 4.3 mmol/l, urea 6.2 mmol/l, and creatinine 98 µmol/l.

She underwent flexible sigmoidoscopy after being given a sodium phosphate enema (Fleet Ready-to-use; De Witt) the night before (day 1). Colonoscopy was performed on day 4 after she took two sachets of oral sodium phosphate solution (Fleet Phospho-soda; De Witt). Histological findings were consistent with chronic active ulcerative colitis. She was discharged and prescribed mesalazine.

On day . . . [Full text of this article]


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