Kidney injury and other complications related to colonoscopy in inpatients at a tertiary teaching hospital

• Published in: Clinics (São Paulo, Brazil) Brazil), 2018-01, Vol.73, p.e456-e456, Article e456
• Main Authors: Ivanovic, Ligia Fidelis, Silva, Bruno C, Lichtenstein, Arnaldo, de Paiva, Edison Ferreira, Bueno-Garcia, Maria Lucia
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - etiology; Adult; Aged; Aged, 80 and over; Colonoscopy; Colonoscopy - adverse effects; Colorectal Neoplasms - diagnosis; Complications; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Hospitals, Teaching; Humans; Kidney Injury; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Original; Retrospective Studies; Risk Factors; Tertiary Care Centers; Young Adult
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.6061/clinics/2018/e456

To describe clinical complications related to colonoscopy in inpatients with multiple diseases. Among the known complications, acute kidney injury was the primary focus. This was an observational retrospective study of 97 inpatients. Data relating to age; gender; comorbidities; current medication; blood tests (renal function, blood glucose and LDL cholesterol levels); length of hospital stay; indication, results, and complications of colonoscopies; and time to the development of kidney injury were collected between June 2011 to February 2012. A total of 108 colonoscopies (9 screening and 88 diagnostic) were conducted in 97 patients. Renal injury occurred in 41.2% of the patients. The univariate analysis revealed that kidney injury was related to the use of diuretics, statins, calcium channel blockers, and angiotensin converting enzyme inhibitor; however, the multivariate analysis showed that only the use of diuretics was associated with kidney injury. The occurrence of kidney injury and the time to its development were independent of the previous glomerular filtration rate as calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The use of diuretics was the only independent variable associated with the development of kidney injury in inpatients with multiple comorbidities who underwent colonoscopy. The occurrence of kidney injury and the time to its development were independent of previous CKD-EPI-based assessments of renal function. These results highlight the increased risk of colonoscopy in such patients, and its indication should be balanced strictly and perhaps avoided as a screening test.