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Increased serum phosphate levels and calcium fluxes are seen in smaller individuals after a single dose of sodium phosphate colon cleansing solution: a pharmacokinetic analysis
Author(s) -
EHRENPREIS E. D.
Publication year - 2009
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2009.03987.x
Subject(s) - phosphate , ingestion , calcium , sodium , medicine , endocrinology , pharmacokinetics , urine , chemistry , zoology , biochemistry , biology , organic chemistry
Summary Background Sodium phosphate containing colonoscopy preparations may cause electrolyte disturbances and calcium‐phosphate nephropathy. Decreased body weight is an unexplored risk factor for complications with sodium phosphate ingestion. Aim To perform a pharmacokinetic analysis of a single dose of Fleet Phospho‐Soda in smaller and larger individuals. Methods Seven subjects weighing <55 kg (Group I) and six weighing >100 kg (Group II) consumed 45 mL Fleet Phospho‐Soda. Serum electrolytes were measured. Hydration was closely maintained by monitoring weight, fluid intake and total body water. Results Marked increases in serum phosphate were seen in Group I compared to Group II. For example, mean serum phosphate at 120 min was 7.8 ± 0.5 mg/dL in Group I and 5.1 ± 0.8 mg/dL in Group II ( P < 0.001). Normalized area under the phosphate vs. time curve for Group I was 1120 ± 190 mg/dL*min and 685 ± 136 mg/dL*min for Group II ( P < 0.001). Twelve‐hour urine calcium was lower in Group I (16.4 ± 7.6 mg) than in Group II (39.2 ± 7.8 mg, P < 0.001). Conclusions Increased serum phosphate occurs in smaller individuals after ingestion of sodium phosphate preparations, even with strict attention to fluid intake. Smaller body weight poses a potential risk for calcium‐phosphate nephropathy.