聚乙二醇作为结肠镜肠道清洗剂对急性肾损伤的影响

Gaurav Chhetri, A. Baral, R. Hada, A. Sedhain, B. Khatri, K. Dahal, Albina Piya, Anurag Prasad Singh, B. Basnet
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引用次数: 0

摘要

简介:使用聚乙二醇基溶液是结肠镜检查肠道准备的金标准。然而,聚乙二醇的使用可能与急性肾损伤的风险有关。我们的目的是发现急性肾损伤和危险因素与急性肾损伤发展的患者使用聚乙二醇结肠镜检查。材料和方法:这是一项在Bir医院肾内科和消化内科进行的观察性研究。使用聚乙二醇进行结肠镜检查的患者被纳入研究并评估急性肾损伤;其发生率、危险因素与急性肾损伤的关系及3个月急性肾损伤的预后(完全恢复或无恢复)。结果:患者平均年龄45.81±18.60岁,男性居多(60%)。在48名研究参与者中,4名(8%)发生急性肾损伤。多因素回归分析显示,慢性肾病、慢性肝病、充血性心力衰竭以及非甾体类抗炎药、血管紧张素受体阻滞剂和利尿剂的使用是影响聚乙二醇患者急性肾损伤发生的预测因素。结论:证据强烈表明,在没有既往存在肾脏疾病、合并症或使用药物的患者中;使用聚乙二醇作为肠道清洗剂结肠镜检查后肾脏损害的风险很低。在存在肾功能障碍的危险因素时,应谨慎使用聚乙二醇。
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Acute Kidney Injury in Patients Using Polyethylene Glycol as Bowel Cleansing Agent for Colonoscopy
Introduction: The use of polyethylene glycol-based solutions is the gold standard for bowel preparation for colonoscopy. However, polyethylene glycol use might be associated with the risk of acute kidney injury. We aim to find out acute kidney injury and risk factors associated with the development of acute kidney injury in patients using polyethylene glycol for colonoscopy.Materials and Methods: This was an observational study conducted in the Department of Nephrology and Gastroenterology, Bir hospital. Patients who underwent colonoscopy using polyethylene glycol were included in the study and assessed for acute kidney injury; its incidence, association of risk factors with acute kidney injury, and outcome (complete recovery or no recovery) of acute kidney injury by 3 months.Results: The mean age of the patients was 45.81 ± 18.60 years with the majority of the patients being male (60%). Out of 48 study participants, 4(8%) develop acute kidney injury. Multivariate regression analysis depicted that chronic kidney disease, chronic liver disease, congestive cardiac failure, and use of non-steroidal anti-inflammatory drugs, angiotensin receptor blockers, and diuretics drugs were the predictors which significantly influenced the occurrence of acute kidney injury in patients using polyethylene glycol.Conclusions: The evidence strongly suggests that in patients without preexisting renal disease, comorbidities, or use of drugs; the risk of renal impairment is low after colonoscopy using polyethylene glycol as a bowel cleansing agent. In the presence of risk factors for renal dysfunction, polyethylene glycol should be used cautiously.
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