Increased Risk of Colonic Perforation During Colonoscopy in Hemodialysis Patients

Colonoscopies are relatively benign procedures. They are done commonly and can be life saving. Furthermore, aside from "the prep" and anxiety associated with the unpleasant nature of this procedure complications are rare. The most dangerous complication is a perforation of the colon. A perforation of the colon is rare but carries a high mortality rate.

An article in Clinical Gastroenterology and Hepatology takes a look at hemodialysis patients who have undergone colonoscopies. It is a retrospective study of more than 15,000 patients in Japan who had colonoscopies between 2001 and 2008. Approximately 1100 hemodilaysis patients were compared to 14,000 controls. There was 5 colon perforations in the 1100 HD patients, whereas there was only 3 perfs in the 14,000 controls. This was a statistically significant difference and the cause is postulated to be from beta-2 microglobulin deposition in the colon wall.

As is the case with all retrospective studies flaws can be found, and the Japanese HD patient doesnt necessarily equate to the HD patient in the USA. Nevertheless, there may be a higher risk of this potentially lethal complication and certainly something to be aware of.