Comparing Bowel Preparation Quality in Chronic Kidney Disease Patients: Low-Dose Polyethylene Glycol (PEG) vs. Low-Dose PEG with SenaGraph

Renal failure presents a critical concern in patients requiring colon preparation for colonoscopy, particularly in those with chronic kidney disease (CKD). In contemporary practice, polyethylene glycol (PEG) serves as a widely employed agent, while herbal alternatives like SenaGraph, standardized dry extract of Senna leaves (Cassia angustifolia L.), have demonstrated satisfactory efficacy. This study aimed to compare the quality of bowel preparation in CKD patients using low-dose PEG with and without Sena Graph.

This randomized clinical trial enrolled 122 patients with CKD who underwent colonoscopies at Imam Hussein Hospital in Tehran, Iran, during 2018 and 2019. Patients were randomly assigned to receive either PEG with SenaGraph or PEG alone. Comparative assessments included the Ottawa Score and measurements of sodium, potassium, urea, and creatinine levels.

The study findings revealed that the mean Ottawa score was deemed acceptable (Ottawa score 0 or 1) in 90.2% of patients receiving PEG with SenaGraph and in 78.7% of patients in the PEG-only group, with statistically significant difference (P = 0.049). Alterations in sodium, potassium, urea, and creatinine levels showed no significant differences between the two groups (P > 0.05).

This investigation suggests that, in CKD patients requiring colonoscopy, the addition of Sena Graph to PEG could improve the efficacy of PEG. Furthermore, both agents exhibit a comparable safety profile for bowel preparation.