在口服磷酸鈉瀉劑愈來愈被廣泛用於大腸內視鏡鏡檢前腸道準備的情況下，近來有愈來愈多急性腎臟損傷的案例被報導。流行病學發現，於腎臟功能正常或接近正常的人，發生急性磷酸鹽腎病變的發生率約為1~4%。急性磷酸鹽腎病變在臨床上通常沒有明顯的症狀或徵象，可以在使用口服磷酸鈉瀉劑後數天到數個星期甚至在好幾個月後才被發現。發生的主要原因與口服磷酸鈉瀉劑含有相當高量的磷相關，大量的磷酸鈣沉積於腎臟的上皮細胞與腎小管，而進一步造成腎臟細胞的破壞。此外，口服磷酸鈉瀉劑也會造成電解質的不平衡：包括高血磷、低血鈣、低血鉀、高血鈉，而表現出一些急性的臨床症狀。預防急性磷酸鹽腎病變及減少磷酸鈉的腎毒性的方法，首先是要避免使用這類藥劑於高危險群病患 (如病人的年齡過大、慢性腎臟病患者、使用ACEI或ARB治療的高血壓病患、糖尿病患等等)；另外，可以將標準磷酸鈉瀉劑的劑量稍為改變：可以減少第二次給予的磷酸鈉量，或拉長兩次給予藥劑的間隔，或使用其他不含磷之腸道準備劑。在大腸鏡檢之後，臨床醫師應該後續追蹤病患有無任何腎功能或電解質異常，以期能早期發現而加以治療。

More and more case reports of acute kidney injury are published nowadays because of bowel cleansing with oral sodium phosphate before colonoscopy. Epidemiological studies disclose that the incidence of acute
phosphate nephropathy in patients with normal or near-normal renal function could range from 1 to 4%. Without specific symptoms or signs, acute phosphate nephropathy cannot be easily recognized days or months after bowel cleansing with oral sodium phosphate before colonoscopy. The toxicity of oral sodium phosphate is related to its high phosphate content, which damages renal tubular epithelium by forming calcium phosphate crystal inside the epithelial cells, as nephrocalcinosis. In addition, oral sodium phosphate can cause electrolyte imbalance (hyperphosphatemia, hypocalcemia, hypernatremia, hypokalemia) that is sometimes catastrophically symptomatic. To prevent or lessen the toxicity of oral sodium phosphate, it is better to avoid such bowel preparation agents in the high-risk patients (old age, chronic kidney disease, hypertension receiving ACEI or ARB,and diabetes). Besides, modifying current standard regimen of oral sodium phosphate by reducing or postponing the second 45mL dose could also be with some help to reduce the toxicity of such a high phosphate load. Finally,after oral sodium phosphate bowel purgatives are used, it is advised to have patients' biochemistry and electrolyte exams in order to salvage their possibly deteriorating renal functions.