دورية أكاديمية

Prevalence of hypokalemia before and after bowel preparation for colonoscopy in high-risk patients.

التفاصيل البيبلوغرافية
العنوان: Prevalence of hypokalemia before and after bowel preparation for colonoscopy in high-risk patients.
المؤلفون: Reumkens A; Department of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Heerlen, the Netherlands; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, the Netherlands., Masclee AA; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, the Netherlands., Winkens B; Department of Methodology and Statistics, Maastricht University, Maastricht, the Netherlands; CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands., van Deursen CT; Department of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Heerlen, the Netherlands; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands., Sanduleanu S; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; GROW, School for Oncology and Developmental Biology, Maastricht University, Maastricht the Netherlands., Bakker CM; Department of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Heerlen, the Netherlands.
المصدر: Gastrointestinal endoscopy [Gastrointest Endosc] 2017 Oct; Vol. 86 (4), pp. 673-679. Date of Electronic Publication: 2017 Feb 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Mosby Yearbook Country of Publication: United States NLM ID: 0010505 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6779 (Electronic) Linking ISSN: 00165107 NLM ISO Abbreviation: Gastrointest Endosc Subsets: MEDLINE
أسماء مطبوعة: Publication: St Louis, Mo : Mosby Yearbook
Original Publication: Denver.
مواضيع طبية MeSH: Cathartics/*adverse effects , Colonoscopy/*methods , Diuretics/*therapeutic use , Hypokalemia/*epidemiology , Polyethylene Glycols/*adverse effects , Preoperative Care/*adverse effects, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Hospitalization/statistics & numerical data ; Humans ; Hypokalemia/chemically induced ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Risk ; Risk Factors ; Young Adult
مستخلص: Background and Aims: Bowel preparation for colonoscopy should not cause significant shifts in systemic electrolyte concentrations. We recently encountered 2 cases of severe postcolonoscopy hypokalemia with fatal consequences, prompting us to conduct a study to explore the magnitude of and risk factors for hypokalemia associated with bowel preparation. We paid specific attention to higher-risk subgroups, in particular, diuretic users, hospitalized patients, and patients estimated to be at high risk by the gastroenterologist.
Methods: From January 1 to December 31, 2014, we included all patients at risk for hypokalemia (diuretic users, hospitalized patients, and patients estimated at high risk by the gastroenterologist) who underwent colonoscopy at our institution. We measured serum potassium levels before low-volume polyethylene glycol bowel preparation for colonoscopy. In a subset of patients who had normal serum potassium levels before bowel cleansing, serum potassium levels after bowel cleansing also were measured.
Results: In total, 5515 colonoscopies were performed, including 1822 procedures in diuretic users or hospitalized patients. Of these, 77 (4.2%) patients had hypokalemia before bowel cleansing. A logistic regression model showed that hospitalized patients were more likely to have hypokalemia than non-hospitalized patients. 301 patients with normal potassium levels had potassium controls after bowel cleansing, of whom 71 (23.6%) developed hypokalemia. A logistic regression model showed that diuretic users were more likely to develop hypokalemia than those who did not use diuretics.
Conclusions: Hypokalemia is frequently encountered after low-volume polyethylene glycol bowel cleansing in high-risk patients. Additional large-scale studies are needed on the prevalence of hypokalemia in unselected populations undergoing bowel cleansing and on the occurrence of potentially very serious side effects in order to decide on screening of high-risk groups in daily clinical practice. (Clinical trial registration number: NTR5400.).
(Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: Gastrointest Endosc. 2017 Oct;86(4):680-683. (PMID: 28917345)
المشرفين على المادة: 0 (Cathartics)
0 (Diuretics)
3WJQ0SDW1A (Polyethylene Glycols)
تواريخ الأحداث: Date Created: 20170212 Date Completed: 20180530 Latest Revision: 20220331
رمز التحديث: 20240628
DOI: 10.1016/j.gie.2017.01.040
PMID: 28188722
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6779
DOI:10.1016/j.gie.2017.01.040