Ready-to-drink bowel prep effective in patients with mild, moderate renal impairment
A ready-to-drink solution of sodium picosulfate, magnesium oxide and citric acid had similar efficacy as a bowel preparation among patients with normal and impaired renal function, according to research from Digestive Disease Week.
Gautam Mankaney, MD, from the department of gastroenterology, hepatology and nutrition at Cleveland Clinic, said in a recorded audio presentation that bowel preparation can result in fluid shifts and electrolyte imbalances, which leads to poor adaptability among patients with chronic kidney disease.
“Both oral sodium phosphate and polyethylene glycol have been associated with renal injury,” he said.
Researchers conducted a randomized, non-inferiority study that compared the efficacy, tolerability and safety of split dose sodium picosulfate, magnesium oxide and citric acid (SPMC oral solution) to a powder formulation for colon cleansing in adults undergoing non-emergent, outpatient colonoscopy. The primary outcome of the study was overall colon cleansing quality using the modified Aronchick Scale as graded by a treatment-blinded endoscopist.
Investigators conducted a sub-analysis based on patient renal Function. Using the National Kidney Foundation estimated glomerular filtration rate (eGFR), they divided patients into three groups; normal (≥ 90, n = 136), mild impairment (60-89, n = 274) and moderate impairment (30-59 mL/min/1.73m2, n = 38).
Mankeney and colleagues found that among these groups, the endoscopist reported “excellent” or “good” ratings in 87.5%, 88% and 86.6% of patients, respectively. The mean Boston Bowel Prep Score was 7.7, 7.7 and 7.5, respectively.
The rate of adverse events was similar among all groups, and no patients discontinued the SPMC oral solution due to a renal adverse event.
“[The SPMC oral solution’s] efficacy, assessed by colon cleansing was similar across all three renal function groups,” Mankaney said. “So, SPMC oral solution is an option of low-volume colon cleansing in patients with mild or moderate renal impairment.” – by Alex Young
Mankaney GN, et al. Abstract 434. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago (meeting canceled).
Disclosures: Mankaney reports no relevant financial disclosures. Please see the study abstract for all other authors’ relevant financial disclosures.