More concern re: oral phosphate solutions and kidney damage

The PEG solutions that have been widely used for colon cleansing for colonoscopy are very effective but are also widely unpopular with patients. The times I have used it I began gagging a bit long before the giant bottle was emptied. The oral phosphate compounds seemed to offer an improvement as the volume burden was less and the taste arguably a little bit better.

However reports surfaced on renal damage for some using the oral phosphates and accordingly the FDA issued a warning with particular concern expressed regarding those patients who were using certain blood pressure pills, namely the ACEi and the ARBs.

Now we have a recent retrospective report from the Scott and White Clinic in Texas which tends to reinforce the concern. The authors conclude:

Oral sodium phosphate solution preparation is associated with decline in GFR in elderly patients with creatinine levels in the normal range. Its routine use for elective and screening procedures should be discouraged in the elderly population.

I agree- the PEG solutions are safer.