Adverse renal and metabolic effects associated with oral sodium phosphate bowel preparation

Eliot C. Heher, Samuel O. Thier, Helmut Rennke, Benjamin D. Humphreys

Research output: Contribution to journalReview articlepeer-review

77 Scopus citations


Colorectal cancer can be prevented by the removal of adenomatous polyps during screening colonoscopy, but adequate bowel preparation is required. Oral sodium phosphate (OSP), an effective bowel purgative, is available over the counter and requires a substantially lower volume than polyethylene glycol-based preparative agents. Accumulating reports implicate OSP in electrolyte disturbances as well as acute kidney injury (AKI) in a syndrome termed phosphate nephropathy (a form of nephrocalcinosis). Despite published case reports and case series, the actual incidence, risk factors, and natural history of phosphate nephropathy remain largely undefined. Several recent observational studies have provided new information on these important issues while supporting a link between OSP and acute phosphate nephropathy as well as the development of chronic kidney disease in elderly patients, many of whom had a normal serum creatinine at the time of OSP ingestion. This review summarizes current knowledge about the renal complications of OSP, risk factors for its development, and the pathophysiology of acute and chronic kidney damage in nephrocalcinosis.

Original languageEnglish
Pages (from-to)1494-1503
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Issue number5
StatePublished - Sep 2008


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