[Survey of polyethylene glycol effects on serum electrolytes]

Colonoscopy and bowel preparation caused a number of serum electrolytes changes that may be dangerous in heart and kidney diseases and elderly patients. To determine the effect of serum electrolytes in patients who underwent colonoscopy and bowel preparation with PEG [Polyethylene Glycol] in Tehran Imam Khomeini hospital in 2008. Fifty nine patients who had been selected for elective colonoscopy after the detection of exclusion criteria were assessed prospectively. Serum level of sodium and potassium were analysed before bowel preparation with PEG [T[0], before colonoscopy T[1] and immediately after it T[2]. Serum calcium and phosphorus levels were measured just before and after PEG. Four patients [6.8%] did not follow the research protocol and were excluded. Four patients [6.8%] developed hyponatremia in T[1] that continued in T[2]. There were no significant differences in prevalence of Hyponatremia and means of sodium serum levels in T[0], T[1] and T[2]. Although there was a significant trend to decreased means of potassium levels of T[2] versus T[1] [P<0.01], but the maximum prevalence of Hypakalemia was in T[1] [10.9%] with only 3.8% new Hypokaliemia in T[2] and there was no significant difference. The prevalence of Hypocalcemia after PEG was 24% but there was no significant decrease. 36% of patients developed Hypophosphatemia after PEG preparation with a significant decrease in mean of serum Phosphorus level [P<0.05]. There was no significant relationship between electrolytes changes with age and sex. The serum electrolyte changes showed that preparation with PEG is a risk factor for development of Hypophosphatemia Colonoscopy and preparation with PEG may cause a significant decrease in potassium serum level

[Relationship between ADPKD and post renal transplant diabetes mellitus]

Autosomal-dominant polycystic kidney disease [ADPKD], a common hereditary disease, is characterized by the progressive development and enlargement of multiple cysts in both kidneys, and typically resulting in end stage renal disease [ESRD] by the fifth decade of life. Post-transplant diabetes mellitus [PTDM], a common complication after transplantation with an incidence rate of 2.5-20%, is associated with poor graft and patient survival. In few studies, PTDM has been more frequent in ADPKD transplanted patients. In the present study, we investigated whether there is any association between PTDM and ADPKD in our patients. In this prospective study, 140 non-diabetic and nonsmoker successfully transplanted patients [27 ADPKD and 113 non ADPKD patients] were enrolled during three years. Both groups were matched for age, sex, body mass index [BMI], duration of renal replacement therapy before transplantation and also immunosuppressive protocols after transplant. Post-transplant diabetes mellitus was defined as Clinical Practice Guidelines advocated by Canadian Diabetes Association. All patients were followed for 12 months. PTDM occurred in 11.1% of ADPKD patients and in 13.1% of control group which was statistically insignificant [P > 0.05]. The development of PTDM in ADPKD group was not related to sex, age, and hypertension, duration of renal replacement therapy before transplantation, BMI and serum creatinine levels [P > 0.05]. Post-transplant diabetes mellitus appears not to be associated with autosomal-dominant polycystic kidney disease as an etiology of end stage renal disease