PURPOSE: Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients. METHODS: Patients aged over 70 years considered at risk of complication during SPS-MC administration by a physician specialised in care of the elderly were included in this retrospective study. Biochemical parameters pre- and post-CTC and the presence of co-morbidities were recorded. Imaging findings and quality of bowel preparation at CTC were graded by consensus by two radiologists. RESULTS: Of the 72 patients 56% had co-morbidities that caution the use of SPS-MC. No significant changes in serum urea, sodium, potassium or estimated glomerular filtration rate (eGFR) occurred post-CTC (p > 0.10). Serum magnesium increased by 0.11 mmol/L in 14 patients (p = 0.03) without clinical sequelae. Good overall preparation was achieved in 88% of patients, allowing confident identification of signs of colonic neoplasia in 20 patients (27%). A mild increase in serum magnesium but no other significant biochemical disturbance was observed. CONCLUSION: In our group CTC with SPS-MC was safe and effective; however, we advise an alternate preparation be considered in patients with decreased renal function due to decreased magnesium clearance.
PURPOSE: Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients. METHODS:Patients aged over 70 years considered at risk of complication during SPS-MC administration by a physician specialised in care of the elderly were included in this retrospective study. Biochemical parameters pre- and post-CTC and the presence of co-morbidities were recorded. Imaging findings and quality of bowel preparation at CTC were graded by consensus by two radiologists. RESULTS: Of the 72 patients 56% had co-morbidities that caution the use of SPS-MC. No significant changes in serum urea, sodium, potassium or estimated glomerular filtration rate (eGFR) occurred post-CTC (p > 0.10). Serum magnesium increased by 0.11 mmol/L in 14 patients (p = 0.03) without clinical sequelae. Good overall preparation was achieved in 88% of patients, allowing confident identification of signs of colonic neoplasia in 20 patients (27%). A mild increase in serum magnesium but no other significant biochemical disturbance was observed. CONCLUSION: In our group CTC with SPS-MC was safe and effective; however, we advise an alternate preparation be considered in patients with decreased renal function due to decreased magnesium clearance.
Authors: C Daniel Johnson; Mei-Hsiu Chen; Alicia Y Toledano; Jay P Heiken; Abraham Dachman; Mark D Kuo; Christine O Menias; Betina Siewert; Jugesh I Cheema; Richard G Obregon; Jeff L Fidler; Peter Zimmerman; Karen M Horton; Kevin Coakley; Revathy B Iyer; Amy K Hara; Robert A Halvorsen; Giovanna Casola; Judy Yee; Benjamin A Herman; Lawrence J Burgart; Paul J Limburg Journal: N Engl J Med Date: 2008-09-18 Impact factor: 91.245
Authors: Ayso H de Vries; Marjolein H Liedenbaum; Shandra Bipat; Roel Truyen; Iwo W O Serlie; Rutger H Cohen; Saskia G C van Elderen; Anneke Heutinck; Oskar Kesselring; Wouter de Monyé; Lambertus te Strake; Tjeerd Wiersma; Jaap Stoker Journal: Eur Radiol Date: 2009-03-20 Impact factor: 5.315
Authors: Ki Hwan Song; Wu Seok Suh; Jin Sik Jeong; Dong Sik Kim; Sang Woo Kim; Dong Min Kwak; Jong Seong Hwang; Hyun Jin Kim; Man Woo Park; Min Chul Shim; Ja-Il Koo; Jae Hwang Kim; Dae Ho Shon Journal: Ann Coloproctol Date: 2014-10-28