Anorexia Nervosa and the Kidney

Bouquegneau, Antoine; Dubois, Bernard; Krzesinski, Jean-Marie; Delanaye, Pierre

doi:10.1053/j.ajkd.2012.03.019

Cited by 84 publications

(95 citation statements)

References 54 publications

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“…40 Patients with AN may lose renal concentrating ability, which can result in high urine output and inaccurate specific gravity measurements on urinalyses. [83][84][85][86] Hematologic Bone marrow hypoplasia is seen in lowweight EDs, primarily leukopenia and anemia, with rare cases of thrombocytopenia. Leukopenia is not thought to increase infection risk, and all dyscrasias resolve with the reversal of malnutrition.…”

Section: Cardiovascular Systemmentioning

confidence: 99%

Eating Disorders in Children and Adolescents: State of the Art Review

2014

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This is the 3rd in our series on Adolescent Health. abstract Despite their high prevalence, associated morbidity and mortality, and available treatment options, eating disorders (EDs) continue to be underdiagnosed by pediatric professionals. Many adolescents go untreated, do not recover, or reach only partial recovery. Higher rates of EDs are seen now in younger children, boys, and minority groups; EDs are increasingly recognized in patients with previous histories of obesity. Medical complications are common in both full and subthreshold EDs and affect every organ system. No single cause of EDs has emerged, although neurobiological and genetic predispositions are emerging as important. Recent treatment paradigms acknowledge that they are not caused by families or chosen by patients. EDs present differently in pediatric populations, and providers should have a high index of suspicion using new Diagnostic and Statistical Manual, 5th edition diagnostic criteria because early intervention can affect prognosis. Outpatient family-based treatment focused on weight restoration, reducing blame, and empowering caregivers has emerged as particularly effective; cognitive behavioral therapy, individual therapy, and higher levels of care may also be appropriate. Pharmacotherapy is useful in specific contexts. Full weight restoration is critical, often involves high-calorie diets, and must allow for continued growth and development; weight maintenance is typically inappropriate in pediatric populations. Physical, nutritional, behavioral, and psychological health are all metrics of a full recovery, and pediatric EDs have a good prognosis with appropriate care. ED prevention efforts should work toward aligning with families and understanding the impact of antiobesity efforts. Primary care providers can be key players in treatment success.

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Section: Cardiovascular Systemmentioning

confidence: 99%

Eating Disorders in Children and Adolescents: State of the Art Review

2014

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“…Eating disorder itself can result in acute kidney injury and chronic renal insufficiency (Bouquegneau et al 2012). In patients with anorexia nervosa, the prevalence of hypokalemic nephropathy is known to be 15-20% (Riemenschneider and Bohle 1983), and the prevalence of end-stage renal disease can be as high as 5.2% (Zipfel et al 2000).…”

Section: 6mentioning

confidence: 99%

“…In patients with anorexia nervosa, the prevalence of hypokalemic nephropathy is known to be 15-20% (Riemenschneider and Bohle 1983), and the prevalence of end-stage renal disease can be as high as 5.2% (Zipfel et al 2000). Bingeeating/purging subtype disorder is frequently associates with episodes of acute kidney injury due to volume depletion (Bouquegneau et al 2012). Gitelman's syndrome is basically salt-losing tubulopathy.…”

Section: 6mentioning

confidence: 99%

Gitelman’s Syndrome with Vomiting Manifested by Severe Metabolic Alkalosis and Progressive Renal Insufficiency

Lee

Han

2013

Tohoku J. Exp. Med.

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Gitelman's syndrome is an autosomal recessive salt-losing tubulopathy showing hypokalemic hypomagnesemic hypocalciuria with metabolic alkalosis and hyperreninemic hyperaldosteronism. This syndrome is caused by mutations in the SLC12A3 gene that encodes sodium-chloride cotransporter expressed at the apical membrane of renal distal convoluted tubule. Symptoms and renal outcomes of Gitelman's syndrome are, in general, mild and benign, and renal insufficiency from Gitelman's syndrome associated with long-standing hypokalemia and volume depletion is extremely rare. Herein, we report a 27-year-old male patient with Gitelman's syndrome who manifested renal failure, hypokalemia, severe metabolic alkalosis and altered mentality. About one year ago, the patient had been transferred to Seoul National University Hospital, because of unsolved hypokalemia, and was diagnosed as Gitelman's syndrome by clinical features and genetic analysis of the SLC12A3 gene. The patient carries a missense mutation at one allele of SLC12A3 gene (c.781C>T, p.Arg261Cys). His mother is also heterozygous for the same mutation and she had a history of hypokalemia. On this admission, the patient had recurrent bouts of vomiting induced by psychiatric eating disorder and showed severe volume depletion with hypotension, azotemia and metabolic alkalosis. Intense hydration therapy and emergency hemodialysis transiently improved his fluid-electrolyte imbalance and renal function. However, renal dysfunction progressively deteriorated despite the medical treatment. Our findings suggest that even in Gitelman's syndrome, constant monitoring for volume status and other comorbid conditions should be employed to prevent progressive renal injury.

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“…In addition, anorexia, which is usually a postpuberty disease, is a cause of urolithiasis, with 5% of anorexia patients forming kidney stones [11], which are usually calcium oxalate, but which may be ammonium urate [12,13]. The later being stones that develop in cases of decreased urinary output, increased urine ammonium with hypophosphaturia, and the hyperchloremic acidosis associated with diarrhea [14]. Anorexia and any other identiied primary disease should be treated before metaphylaxis.…”

Section: Introductionmentioning

confidence: 99%

Metaphylaxis in Pediatric Urinary Stone Disease

Kaygısız¹

2017

Updates and Advances in Nephrolithiasis - Pathophysiology, Genetics, and Treatment Modalities

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Anorexia Nervosa and the Kidney

Cited by 84 publications

References 54 publications

Eating Disorders in Children and Adolescents: State of the Art Review

Eating Disorders in Children and Adolescents: State of the Art Review

Gitelman’s Syndrome with Vomiting Manifested by Severe Metabolic Alkalosis and Progressive Renal Insufficiency

Metaphylaxis in Pediatric Urinary Stone Disease

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