Kidney disease as a medical complication of eating disorders

Puckett, Leah; Mehler, Shoshana; Mehler, Philip S.

doi:10.1038/s41581-022-00610-y

Cited by 2 publications

(8 citation statements)

References 9 publications

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“…Creatinine is generated by muscle mass or dietary intake, usually from animal protein products [ 2 ]. Therefore, eGFR methods that utilize creatinine less accurately reflect kidney function in patients with very high or low muscle mass, low protein intake, and hypovolemia compared to healthy individuals [ 2 , 11 , 12 ] as creatinine can be falsely low in AN patients [ 12 ].…”

Section: Measuring Kidney Function In Eating Disordersmentioning

confidence: 99%

“…There is a lack of large population-based studies regarding AKI and progression to CKD in patients with AN, and many of the available studies do not differentiate between subtypes of AN, so it is difficult to define the prevalence of kidney disease in this population. However, some data estimates > 5% of patients with AN will develop end-stage renal disease (ESRD) after 21 years (AN subtype not specified) [ 7 , 11 ]. ESRD refers to irreversible loss of kidney function expected to result in death within days or weeks from complications such as hyperkalemia (serum potassium levels > 5 mEq/L) or pulmonary edema without intervention with dialysis or renal transplant [ 14 ].…”

Section: Prevalence Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

“…Kidney disease in ED is complex and incompletely understood [ 8 , 11 ]. While kidney disease is observed in both AN and BN, it can be challenging to clearly delineate causes attributed to type or subtype as studies often do not distinguish between these.…”

Section: Pathophysiology Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

“…Low protein intake, which can be seen in individuals with restrictive diets, leads to impaired GFR and renal plasma flow. Protein-calorie malnutrition interferes with the kidney’s ability to concentrate urine and excrete sodium and acid [ 11 ]. While some data indicate low BMI as a risk factor for kidney disease, impaired kidney function is also seen in AAN, demonstrating the potential effects of starvation on renal function even at higher weight [ 8 , 17 ].…”

Section: Pathophysiology Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

“…While hypokalemia has been reported in approximately 14% of patients with AN-R admitted to inpatient or residential care, this finding should prompt screening for covert purging behaviors as this is a possible explanation of hypokalemia in patients with a diagnosis of AN-R [ 9 , 11 , 20 ]. In fact, one study found the most common etiology in patients without known eating disorders referred to a specialist to determine the cause of chronic hypokalemia was covert purging from bulimia; another plausible explanation, however, is very early complications of refeeding leading to hypokalemia.…”

Section: Pathophysiology Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

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Renal and electrolyte complications in eating disorders: a comprehensive review

Puckett

2023

J Eat Disord

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Eating disorders are psychiatric disorders with significant and widespread medical complications, including renal disorders. Renal disease is not uncommon in patients with eating disorders but is often unrecognized. It includes both acute renal injury and progression to chronic kidney disease requiring dialysis. Electrolyte abnormalities including hyponatremia, hypokalemia, and metabolic alkalosis are common in eating disorders and vary depending on whether patients engage in purging behaviors. Chronic hypokalemia due to purging in patients with anorexia nervosa-binge purge subtype or bulimia nervosa can lead to hypokalemic nephropathy and chronic kidney disease. Additional electrolyte derangements are seen during refeeding, including hypophosphatemia, hypokalemia, and hypomagnesemia. Patients can also develop Pseudo-Bartter’s syndrome which leads to edema and rapid weight gain in patients who cease purging behavior. Clinicians and patients should be aware of these complications in order to provide education and early detection and prevention.

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Section: Measuring Kidney Function In Eating Disordersmentioning

confidence: 99%

Section: Prevalence Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

Section: Pathophysiology Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

Section: Pathophysiology Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

Section: Pathophysiology Of Kidney Disease In Eating Disordersmentioning

confidence: 99%

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Renal and electrolyte complications in eating disorders: a comprehensive review

Puckett

2023

J Eat Disord

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Endocrine and renal manifestations of eating disorders in children

Burlaka,

Romanenko

2024

MTT

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Eating Disorders (EDs), which are classified as psychoneurotic diseases, are defined by disordered eating habits that may involve insufficient or excessive food consumption, which is detrimental to a person's physical and mental health. According to current data, there is a close connection between eating disorders and damage to endocrine system and kidney functions. Patients with anorexia nervosa need both psychological and physical support. This review describes the underlying pathophysiological processes of the endocrine, renal, and electrolyte disturbances observed in patients with EDs. The purpose of the review is to present all aspects related to disorders of the function of the endocrine system and kidneys in EDs. Human organisms can adapt to changes in environment, including nutrition. However, compensatory mechanisms are temporary in terms of adaptation to malnourishment. One of the systems which is susceptible and impacted is the endocrine system. Disorders of the endocrine system in patients with EDs are multi-vector and include disorders of the hypothalamic-pituitary-gonadal system, thyroid gland, insulin system, growth hormone, gonads, leptin-ghrelin system. Background metabolic disorders in EDs are hypokalemia, hyponatremia, hypomagnesemia, metabolic alkalosis. They participate in the occurrence and progression of kidney damage. The compensatory functions of the kidneys are preserved until a certain time, which is determined by the level of water-electrolyte, metabolic disorders, tubulo-interstitial damage. The main morphological forms of kidney damage in patients with EDs are nephrocalcinosis and nephrolithiasis, clinical forms are acute kidney damage and chronic kidney disease. The multi-vector nature of disorders in EDs requires a comprehensive multidisciplinary approach. Management of patients with EDs requires a multidisciplinary approach. Keywords: endocrine disorders, kidney damage, pathophysiology.

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Kidney disease as a medical complication of eating disorders

Cited by 2 publications

References 9 publications

Renal and electrolyte complications in eating disorders: a comprehensive review

Renal and electrolyte complications in eating disorders: a comprehensive review

Endocrine and renal manifestations of eating disorders in children

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