Question about CKD and having a colonoscopy - Kidney Disease

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Question about CKD and having a colonoscopy

LoveNeroli profile image
30 Replies

Hi,

I have recently been diagnosed with CKD Stage 2. I am also scheduled to have a colonoscopy in December.

I am scared that the laxative solution and the phosphate enema that I have to take as part of preparing for the colonoscopy will damage my kidneys even more than they already are. I am also worried that the sedative I have to take as part of the procedure might do the same thing.

Does anyone have any advice or information on whether the laxative called polyethylene glycol (PEG), phosphate enemas, and/or the sedative called propofol might cause any kidney damage?

Thanks

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30 Replies
Bassetmommer profile image
BassetmommerNKF Ambassador

They have better less evasive products that you can request for a colonoscopy. No phosphate enema. And less harsh evacuators. Ask your doctor and tell him you are protecting your kidneys. Not sure about the sedative. I had a pooper scope done when I was stage 4 and they were very careful in the products they gave me.

LoveNeroli profile image
LoveNeroli in reply toBassetmommer

Thank you so much Bassetmommer. I will take your advice and ask about less harsh products as well, because my goal is to preserve my numbers as long as I can.

orangecity41 profile image
orangecity41NKF Ambassador in reply toBassetmommer

My gastro Doctor made adjustments due to CKD for colonoscopy.

LoveNeroli profile image
LoveNeroli in reply toorangecity41

Thanks orangecity. Do you know what the adjustments were exactly.

orangecity41 profile image
orangecity41NKF Ambassador in reply toLoveNeroli

I really do not know all the details but got child size chemicals. I am a small size person.

LoveNeroli profile image
LoveNeroli in reply toorangecity41

Thank you. I am small and thin too.

Darlenia profile image
Darlenia

Agree with Bassetmommer. There are other products that can be used for colonoscopies. Senna, for example, is quite gentle on the kidneys. Others modify their diets a week or so before the procedure reducing the need for harsh meds. As for anesthesia, my hubby, who has gone through all stages of CKD, has been "put under" many times over the past few years for a variety of things, including a colonoscopy. Most all of them involved the use of Propofol. His kidneys stayed stable at the time. Propofol is also one the best for preventing Postoperative Urinary Retention. We're relieved when we hear that's the anesthesia being given.

LoveNeroli profile image
LoveNeroli in reply toDarlenia

Thank you Darlenia, I'm relieved to hear that about the propofol.

Jonquiljo profile image
Jonquiljo

My Dr wants me to take “Suprep”. He knows I have a GFR around 55 — says its the only one that cleans well — and that “Suprep” is OK except for extreme kidney dysfunction.

Propofol will be the sedative.

Maybe someday they will be able to “transport “ stuff out like in Star Trek.

CatOnACloud profile image
CatOnACloud in reply toJonquiljo

Ah ha ha ha! “Beam it on out, Scotty…”

”Yes Sir! Duck, Captain!!!”

Razzy1518 profile image
Razzy1518 in reply toJonquiljo

I took Suprep for my colonoscopy last year. The day before your procedure you can have breakfast, and around lunchtime you go on clear liquids and you can have some sherbet and jello water too. Late afternoon you take 12 Suprep pills and you drink some water at certain intervals. That's it until early morning when you do the same thing again. It's really not too bad and I never had any cramps. Much better than drinking the other stuff. I would take it again. They used Propofol as the sedative and I did fine. Good luck with your procedure!

LoveNeroli profile image
LoveNeroli in reply toRazzy1518

Thank you

TopazForests profile image
TopazForests in reply toJonquiljo

Even better, we the pill that Bones gave that older lady who jumped off the gurney and danced in the halls saying "Doctor gave me a pill and I grew a new kidney!"

KidneyCoach profile image
KidneyCoachNKF Ambassador

I'm stage 5. I've had several colonoscopies, the most recently while in hospital February and March. Gave me Miralax with flavored water. My first was 3 months after beginning dialysis. I was dehydrated and they couldn't get an I.V. for twilight meds, so I did cold turkey. No pain meds. Aye, I survived.

CatOnACloud profile image
CatOnACloud

I just had my first, USA. I asked and was told Suprep was ok for my CKD3. Propofol should really be okay…it is great because you won’t remember much. That’s a mercy at times.

One thing to watch out for are DYES AND CONTRASTS. Many scans (MRI, CT, PET, etc.) have contrast they need to give you via IV. When I had a mass of blood clots in my lung the CT without contrast didn’t show them. They had to give me contrast. They specifically flushed the line with saline a couple times after contrast. I drank water after. It’s always good to mention during any kind of scans.

Keep researching! Keep asking, until you know how to protect your kids ;-) Best

LoveNeroli profile image
LoveNeroli in reply toCatOnACloud

Thank you

lowraind profile image
lowraind

From my own research:

Different medical centers recommend different ways to prepare the bowel for a colonoscopy. Here's a suggested sequence:

A few days before the colonoscopy: Start eating a low-fiber diet: no whole grains, nuts, seeds, dried fruit, or raw fruits or vegetables.

The day before the colonoscopy: Don't eat solid foods. Instead, consume only clear liquids like clear broth or bouillon, black coffee or tea, clear juice (apple, white grape), clear soft drinks or sports drinks, Jell-O, popsicles, etc.

The afternoon or evening before the colonoscopy: Drink the first dose of the prescribed laxative preparation. The exact instructions depend on the bowel prep used and the time of your colonoscopy.

The day of the colonoscopy: As on the previous day, clear liquids only. Don't eat or drink anything two hours before the procedure.

Six hours before your appointment: Drink the second dose of the prep. The American Gastroenterological Association and American College of Gastroenterology recommend the split dose because it cleans the colon more thoroughly. Even after a thorough cleansing, your stomach and pancreas are still making fluids, which flow into the colon. "The more time that elapses after you take the prep, the more likely you are to have fluid in your colon," Dr. Cheney explains.

Throughout the entire prep period: Drink lots of fluids. Keeping hydrated not only clears your colon but also maintains your electrolyte balance.

Certain medical conditions. People with kidney disease and heart conditions often require preps that don't include phosphates or magnesium.

OKShakespeare profile image
OKShakespeare

Wait a minute- "the sedative I have to take " is or at least should not be a requirement. I have had 3 colonoscopies without a sedative. Do I think it was a walk in the park? No. But I lived to tell the tale and if I need to have another colonoscopy will not choose sedation. Why? I can leave the facility where it is performed fully awake, aware, and cognizant. I can go to work directly afterwards and not take to my bed suffering aftereffects of sedation. Colonoscopy without sedation is a bit painful but only for a short period of time.

in reply toOKShakespeare

I had colonoscopy & endoscopy without any sedation/memory erasers. There was just a pinching sensation when they cut out a couple of growths. The endoscopy was the deepest gag I've ever experienced in my life bringing tears to my eyes (through reflex, not by being upset). It was wonderful walking out afterwards and driving home so clear-minded.

TheKidneyKitten profile image
TheKidneyKitten

Hi there, let your gastroenterologist know that you have kidney disease and you are concerned about using the the standard prep solutions. There are other options available, but also know that they may not be covered by your insurance.

LoveNeroli profile image
LoveNeroli in reply toTheKidneyKitten

Ok, thanks.

WYOAnne profile image
WYOAnneNKF Ambassador

Just tell your GI doctor that you have CKD and you need a kidney friendly prep. I have had a transplant and my doctor always makes sure they are careful the products they give me. Never have had any problems with the prep or the sedation.

barbara55109 profile image
barbara55109

Boy times have changed. I had ulcerative colitis from 16-30 and NEVER had any sleepy meds. I just had to lie there in tears. My colon was removed in 93 so I haven't had a colonoscopy since. You can't scope what isn't there! Not my #1 pain experience though. That was getting a Hickman cath in my neck, through scar tissue, wide awake. That was the worst. Much worse than childbirth or colonoscopy.

allene7 profile image
allene7

My first colonoscopy I had was with the solution etc like they are wanting you to do I did fine nothing new but was early stage 2 kidney disease then. This time much later stage 4/5 I did a cologuard test and that was simple enough worked great. They didn't want me to use the solution this time. Always best to check with your doctor. Good luck.

LoveNeroli profile image
LoveNeroli in reply toallene7

Thanks

Kidney2014 profile image
Kidney2014

Hi there. I’m a kidney transplant recipient with IgA nephropathy. I just had a colonoscopy today (in Texas), and I’m still in one piece! Similar to what lowraind mentioned, each doctor and each digestive disease center is different. My GI doctor follows the general guidelines from the American Gastroenterological Association.

I was prescribed Plenvu (which is a PEG), split dose. Plenvu is supposedly preferred for those who have severe systemic diseases or issues. I was not prescribed any oral phosphate tablets, and I was not prescribed an enema.

During the bowel prep, I had a major headache and was generally weak. I was dehydrated, so I tried to drink more pedialyte. And it’s OK to take Tylenol (instead of NSAIDs). It’s critical for CKD and transplant patients to stay hydrated. If you feel nauseated, OK to take Zofran (prescription) during the bowel prep.

For the procedure, I was given propofol, which the anesthesiologist said is fine for most patients, including transplant recipients.

Good luck! The bowel prep was the hardest part to endure because it was difficult to stay hydrated and consume so much liquid.

LoveNeroli profile image
LoveNeroli

Thanks

zengirl64 profile image
zengirl64

Thank you for posting this. I never thought about the effects of such a prep on my kidneys. Great information here.

I'm a little late to this thread, but I have had four colonoscopies unfortunately. I was given suprep during the first three, but after learning more about the medication, I personally would ask for something different. I don't believe it harmed my kidneys, but I would rather be safe and there is a black box warning on the box for kidney problems AND there are other options. On my fourth colonoscopy I had 21% kidney function and I had my kidneys checked before and after the procedure. I didn't lose any function and I took miralax for the prep. I didn't have any issues with the Dr being able to see everything and I tolerated it much better so I actually finished it all (the prior three I would start vomiting before I was halfway through).

As a rule of thumb, call your nephrologist about every single new medication you are prescribed to double check. I have had plenty of doctors know about my kidney disease and still prescribe unsafe medication (such as NSAIDS in the hospital after the birth of my child).

LoveNeroli profile image
LoveNeroli

Thank you so much for sharing this.

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