Severe Hyperphosphatemia and Hypocalcemia Caused by Bowel Preparation for Colonoscopy Using Oral Sodium Phosphate in End-Stage Renal Disease

Abstract

Bowel preparations containing oral sodium phosphate have gained increased favor among gastroenterology endoscopists in preference to the traditional polyethylene glycol, likely due to greater patient tolerability and improved cleansing and compliance [1]. Despite the availability of reports in the literature concerning life-threatening metabolic and cardiac abnormalities associated with the use of oral sodium phosphate in patients with renal insufficiency, less than half of respondents in a recent survey among gastrointestinal endoscopists reported its exclusion in this patient population [2]. We report two cases of severe hyperphosphatemia and secondary hypocalcemia due to administration of an oral sodium phosphate-containing bowel preparation in patients with chronic renal insufficiency.