We describe case of patient which developed a high level of serum kreatinin, after phosphate administration for bowel cleansing before coloscopy and irigography. Normal urine volume and frequency was observed.
Renal biopsy showed acute phosphate tubular nephropathy. After 6 months due to dehydration high serum kreatinin level appeared again and patients was introduced into chronic haemodialysis program.
The authors point to danger of phosphate cleansing bowel solution before endoscopy and radiography in patients with stones or infection of urinary tract, diabetes mellitus and using drug influencing calcium phosphate metabolism etc. This nephropathy leads in all cases in chronic renal insuficiency of different grading including hemodialysis or kidney transplantation.
In above mentioned cases the authors prefer macrogol solutions for bowel cleansing.