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Concerns have emerged about the safety of sodium phosphate (NaP) as a colonoscopy preparation since post-prep nephrocalcinosis and acute renal failure were reported in patients with previously normal renal function (Journal Watch Gastroenterology Jan 31 2006). However, NaP is tolerated better and is more effective than polyethylene glycol (PEG)–based preparations, particularly if the NaP dosing is split: one 45-mL dose the evening before and another the morning of the examination.
To help identify the optimal preparation strategy, investigators in Canada initiated a randomized trial to compare oral NaP (two 45-mL bottles, given 6, 12, or 24 hours apart) with PEG (4 L) in 200 outpatients who were referred for colonoscopy. Exact NaP preparatio…