What is a potential adverse effect of sodium phosphate as a bowel prep solution?

Sodium phosphate is a commonly used bowel prep solution due to its osmotic properties, which help in cleansing the intestines before procedures like colonoscopy. However, one significant potential adverse effect of sodium phosphate is its association with nephrocalcinosis, particularly in certain patient populations.

Nephrocalcinosis refers to the deposition of calcium salts in the kidney, which can lead to various renal complications. Sodium phosphate can cause an increase in serum phosphate levels, and in some individuals, particularly those with pre-existing kidney issues or certain metabolic conditions, this can result in the formation of calcium-phosphate complexes. This condition may be exacerbated by dehydration, which can occur with the use of sodium phosphate if adequate hydration is not maintained.

Therefore, when considering the potential adverse effects associated with sodium phosphate as a bowel prep solution, nephrocalcinosis stands out as a significant risk, especially in susceptible individuals. Understanding this adverse effect is crucial for clinicians when deciding on the appropriate bowel prep method, particularly for patients with existing renal concerns.