Anorexia nervosa is an eating disorder, more prevalent in people who are scared of gaining weight. Self-starving to prevent weight gain often results in severe weight loss. Rapid loss of weight causes several medical complications secondary to malnutrition, some could be potentially fatal. One of the diseases associated with anorexia nervosa is a kidney disorder.1 In this article, we will discuss about kidney disease as a result of Anorexia Nervosa.
Risk Factors for Anorexia Nervosa Affecting Kidneys
Anorexia nervosa is an eating disorder. Risk factors of anorexia disorder resulting in kidney malfunction are as follows-
- Female- Anorexia nervosa is more common among female who are apprehensive about gaining weight.
- Malnutrition- Malnutrition resulting in protein deficiency causes kidney damage.
- Diet Apprehension- Individual who are apprehensive eventually start limiting their daily food intake and diet.
- Cellular Damage- The effect of inadequate protein, carbohydrate, fat, mineral and vitamin intake results in cellular damage and mental abnormal changes.
- Hypotension- Dehydration and cardiac complications causes low blood pressure and bradycardia. Low blood pressure may result in damage of glomerulus and renal tubules.
What Are The Different Methods Used To Lose Weight Resulting In Kidney Damage?
Most of the cases of anorexia nervosa follow restriction of diet and calories. Few other methods used to loose weight are as follows-
- Laxatives- Use of self-prescribed laxative sold on shelf in pharmacy.
- Diet Pills- Diet pills are mostly purchased through Internet pharmacy.
- Ipecac Syrup- Induces vomiting by stimulating stomach mucosa.
- Water Pills- Also known as diuretics. Water pills cause loss of water from body and results in dehydration and loss of weight.
What Are The Abnormal Systemic Effects Of Anorexia Nervosa Associated With Kidney Damage?
Systemic effects of anorexia nervosa associated with kidney disease are as follows-
- Osteoporosis- Lack of calcium and protein causes osteoporosis.
- Cardiovascular Abnormalities-
- Changes in heart rate- bradycardia (low heart rate) or tachycardia (rapid heart rate)
- Changes in blood pressure- Hypotension
- CNS (Central Nervous System) Effects-
- Dizziness and Drowsiness
- General Metabolic Abnormalities-
- Lack of energy
- Effects of Abnormal Electrolytes-
- Hypokalemia- Hypokalemia is low serum or blood potassium.2 Low potassium level causes abnormal heart rhythm, constipation, fatigue and muscle weakness.
- Cognitive Abnormalities-
- Rapid Mood Swing
Causes of Anorexia Nervosa Affecting Kidneys
Anorexia Nervosa also causes kidney injury, dysfunction with eventual renal failure.
- Protein Deficiency- Inadequate ingestion of proteins in the body due to lack of eating.
- Damage of Renal Tubule- Lack of protein causes damage of renal tubular cells.
- Damage of Glomeruli- Hypotension and low protein in blood causes capillary and glomerular vessel damage.
- Kidney Stone- Individuals with Anorexia Nervosa are also prone to develop kidney stones.
Complications Caused By Anorexia Nervosa Affecting Kidneys
Kidney malfunction causes abnormal excretion of metabolites, mineral and water resulting in several complications. Complications are described as follows-
- Electrolyte Imbalance-
- Anorexia nervosa can cause acute electrolyte imbalance like hypokalemia or hypophosphatemia along with nephrolithiasis
- As an estimate about 15% of people with Anorexia Nervosa end up having hypokalemic nephropathy.
- Water Retention-
- Impaired metabolism of water results in hypernatremia and edema.
- Chronic Renal Failure-
- Renal tubular damage causes abnormal excretion of mineral, water and metabolites. Results in abnormal electrolytes, dehydration or water retention and metabolites toxicity.
- Glomerulonephritis occurs following capillary and arterial damage of the glomerular blood vessels.
- Glomerulonephritis causes proteinuria; increased blood urea nitrogen and creatinine.
- Hematuria may result in anemia.
Tests for Anorexia Nervosa Affecting Kidneys and Its Related Complications
Whenever a physician suspects an individual has Anorexia Nervosa then they usually run a battery of tests to confirm the diagnosis and to identify potential complications. These usually include:
Physical Examination for Anorexia Nervosa Affecting Kidneys
- A detailed physical evaluation is conducted to look at the vital parameters along with checking the conditions of vital organs of the body like the heart, lungsM/a>, and kidney.
Laboratory Tests for Anorexia Nervosa Affecting Kidneys
The physician may also conduct a detailed laboratory test.
Complete Blood Count (CBC) for Anorexia Nervosa Affecting Kidneys
- Low hemoglobin
- Increase creatinine
- Increase BUN
Urine Examination for Anorexia Nervosa Affecting Kidneys
- Blood in urine
- 24 hours Creatinine Clearance test.3
Treatment for Anorexia Nervosa Affecting Kidneys
Anorexia Nervosa is a tough medical condition to treat as it poses many challenges and is usually difficult to prevent. It is estimated that nearly 4-5% of people with this disease end up dying of this disease and around 25% end up developing chronic eating disorder. As stated, Anorexia Nervosa results in various medical complications including renal dysfunction.
Medical Treatment for Anorexia Nervosa Affecting Kidneys
- Treat dehydration
- Treat protein deficiency
- Treat vitamin and mineral deficiency
- Corticosteroids- Kidney damage is treated with corticosteroid when signs of glomerulonephritis or kidney damage is observed.
- Intravenous Diet Supplement
- Dialysis or renal transplant if kidney function is severely damaged and damage is irreversible.
Psychological Treatment for Anorexia Nervosa Affecting Kidneys
- Psychological evaluation
- Treat cause of anorexia nervosa.
Hence the conclusion is that people with Anorexia Nervosa should be closely monitored both medically and psychiatrically and should be treated early to prevent serious complications.
1. Anorexia nervosa and the kidney.
Bouquegneau A1, Dubois BE, Krzesinski JM, Delanaye P.
Am J Kidney Dis. 2012 Aug;60(2):299-307.
2. Hypokalemic nephropathy in anorexia nervosa.
Liang CC1, Yeh HC.
CMAJ. 2011 Aug 9;183(11):E761.
3. Factors related to renal dysfunction in patients with anorexia nervosa.
Takakura S1, Nozaki T, Nomura Y, Koreeda C, Urabe H, Kawai K, Takii M, Kubo C.
Eat Weight Disord. 2006 Jun;11(2):73-7.