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Renal injury in pediatric anorexia nervosa: a retrospective study

  • Chantal StheneurEmail author
  • Sebastien J. Bergeron
  • Jean-Yves Frappier
  • Olivier Jamoulle
  • Danielle Taddeo
  • Marc Sznajder
  • Anne-Laure Lapeyraque
Original Article

Abstract

Purpose

Although primarily a mental health disorder, anorexia nervosa (AN) has many physical consequences. Among them, the consequences on kidney function are often underestimated. We evaluated renal function in adolescent AN inpatients and investigated the correlation between the GFR and intrinsic patient characteristics.

Methods

A single-center retrospective study was conducted on 51 patients hospitalized for the restrictive type of AN in 2013. Data were divided into: (1) medical history of AN; (2) growth parameters and vital signs upon admission; and (3) blood tests. The glomerular filtration rate (GFR) was calculated using the Cockroft–Gault, MAYO Clinical Quadratic (MCQ), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the Modification of Diet in Renal Disease (MDRD), and Schwartz equations.

Results

The calculated percentages of patients with a GFR below 90 mL/min/1.73 m2 according to the different equations were as follows: Cockroft–Gault, 45%; MDRD, 28%; CKD-EPI, 14%; MCQ, 12%, and Schwartz, 4%. There was a strong association between the body mass index (BMI) and the GFR according to all equations (p < 0.0001). The lowest heart rate was significantly associated with a reduced GFR according to the Cockroft–Gault equation (p = 0.03). The GFR values did not differ significantly after rehydration.

Conclusion

Clinicians should evaluate AN patients for renal complications, especially when the BMI and heart rate are very low. Dehydration was not solely responsible for renal impairment.

Level of evidence

Level III, single-center retrospective cohort study.

Keywords

Anorexia nervosa Renal disease Glomerular filtration Body mass index 

Abbreviations

ALT

Alanine aminotransferase

AN

Anorexia nervosa

CKD-EPI

Chronic kidney disease-epidemiology collaboration

GFR

Glomerular filtration rate

MCQ

MAYO clinic quadratic equation

MDRD

Modification of diet in renal disease

SD

Standard deviation

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

This retrospective study was approved by the hospital ethics committee (number 3891 2014/05/23).

Informed consent

For retrospective studies informed consent is not required.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Adolescent MedicineCHU Sainte-JustineMontrealCanada
  2. 2.Department of PediatricsHôpital Ambroise ParéBoulogneFrance
  3. 3.Department of NephrologyCHU Sainte-JustineMontrealCanada

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