Safety and Efficacy of a Same-Day Low-Volume 1L PEG Bowel Preparation in Colonoscopy for the Elderly People and People with Renal Dysfunction.

Abstract

A same-day low-volume 1L polyethylene glycol (PEG) for bowel preparation before colonoscopy was developed to improve patients' compliance. We aimed to evaluate the efficacy and safety of this regimen especially for the elderly and patients with renal dysfunction. All consecutive patients who underwent colonoscopy in our center from November 2014 to September 2015 were included. Patients undertook a low-residue diet with 10mL sodium picosulfate 1day before colonoscopy. Subsequently, they had 1L low-volume PEG (MoviPrep) and 0.5L water 4h before the examination. Clinical outcomes, including cleansing level using the Boston bowel preparation score (BBPS), in the elderly and special-elderly (65-79 and ≥80years old) were analyzed and compared with the non-elderly (18-64years old). Additionally, patients with renal dysfunction were analyzed with respect to both complications and changes in blood parameters. A total of 5427 patients (mean age: 64.5±13.8) were analyzed. The rate of BBPS≥6 in the elderly (2761 patients), special-elderly (565 patients), and non-elderly (2101 patients) was 94.1, 91.8, and 94.6%, respectively. In the special-elderly, the rate of renal dysfunction was 14.8%, and no severe complications were detected after colonoscopy. Additionally, there were no severe complications in 86 patients with renal dysfunction, though elevation of hematocrit was shown after intake of 1L PEG (before, 36.7±6.1 vs. after, 39.0±5.7, P=0.006). Our study shows the safety and efficacy of same-day low-volume 1L PEG bowel preparation in colonoscopy for the elderly and patients with renal dysfunction.