Recent research has raised concern that in rare instances, certain bowel-cleansing preparations that patients drink before a procedure can severely damage the kidneys. These products are oral preparations made with sodium phosphate, and they include prescription Visicol tablets and other over-the-counter versions containing the same active ingredients.
A team of doctors from the Columbia College of Physicians and Surgeons recently reported 21 cases of acute kidney failure from these products, including three that led to permanent dialysis and one to a kidney transplant. The study appeared in the November 2005 issue of the Journal of the American Society of Nephrology
Until recently, only certain patients were warned about the risks of these phosphate-based bowel preparations, including those with impaired kidneys or congestive heart failure. The new research broadens the list of people who may be vulnerable to kidney damage to include healthy elderly people, patients with unstable angina, people who have had heart attacks, and anyone who is especially likely to become dehydrated, including people who take certain hypertension drugs and people who do not drink enough fluid to replenish that lost in bowel cleansing.
In the new study, Dr. Markowitz and his colleagues described the findings from the Columbia renal pathology lab. The lab receives kidney tissue samples from 80 to 90 hospitals in 12 states each day. While looking for a source of the phosphate, the doctors noticed the patients had been prescribed a sodium phosphate solution to drink the night before the exam. The doctors decided to investigate all 7,349 kidney biopsy samples received by the laboratory since 2000, looking for cases of nephrocalcinosis. Dr. Markowitz has seen the medical records of people who were healthy before swallowing a phosphate-based bowel cleanser and are now on dialysis, and he wants to make sure every patient understands the risk.
Sodium Phosphate Medications to Treat Constipation Linked to Kidney, Cardiac Injury and Death
Over-the-counter (OTC) sodium phosphate medications used to treat constipation have also been implicated in cases of serious kidney and cardiac harm, and death, according to a warning issued by the U.S. Food and Drug Administration (FDA). The agency warns that using more than one dose of these preparations in a 24-hour period may increase risks for serious kidney and heart injury. Products are marketed under the Fleet brand, as well as under store and generic names.
The agency indicates that it is aware of severe hydration reported in some people who have taken more than the recommended dose of these OTC sodium phosphate preparations, as well as reports of changes in serum electrolyte levels—calcium, sodium, and phosphate. Injuries include serious, adverse kidney and heart damage and death.
Reports revealed that most cases involving significant harm took place following just one larger-than-recommended sodium phosphate dose or more than one dose in a single day. The OTC sodium phosphate products, such as Fleet, may be taken orally or as rectal enemas and are available as single-ingredient products that contain either sodium biphosphate or sodium phosphate or as combination drug product containing both sodium ingredients.
Legal Help For Victims Affected By Fleet Enema
If you or a loved one used a Fleet Enema or Fleet constipation remedy products and suffered side effects, please fill out the form at the right for a free case evaluation by a qualified drug side effects attorney or call us at 1-800-YOURLAWYER (1-800-968-7529).