Department of Medicine, Denver Health Medical Center, Denver, Colorado 80204, USA.
Int J Eat Disord. 2011 Apr;44(3):200-2. doi: 10.1002/eat.20814.
Diuretic abuse as a means of purging is common in patients with bulimia nervosa. We sought to illustrate the pathophysiologic effects of diuretics and purging on a patient with bulimia nervosa's fluid and electrolyte status and to clarify the role of diuretics in the management of volume status during refeeding.
We reviewed the literature pertaining to diuretic abuse, purging, bulimia nervosa, and diuretic therapy.
Purging behaviors lead to volume depletion and a state of heightened aldosterone production. Patients with bulimia nervosa commonly undergo rapid rehydration with intravenous fluid administration. In the setting of hyperaldostreronism, aggressive rehydration leads to avid salt retention and the development of marked amounts of edema.
Providers should understand both the background renal pathophysiology of the patient with bulimia nervosa and the mechanisms of action of diuretics to correctly use diuretics as focused therapeutic agents for this patient population.
利尿剂滥用作为催吐的手段在神经性贪食症患者中很常见。我们旨在阐述利尿剂和催吐对神经性贪食症患者液体和电解质状态的病理生理影响，并阐明利尿剂在再喂养期间容量状态管理中的作用。
我们回顾了有关利尿剂滥用、催吐、神经性贪食症和利尿剂治疗的文献。
催吐行为导致容量耗竭和醛固酮产生增加的状态。神经性贪食症患者通常通过静脉补液进行快速补液。在高醛固酮症的情况下，积极补液会导致盐的过度保留和大量水肿的形成。
提供者应了解神经性贪食症患者的肾脏病理生理学背景和利尿剂的作用机制，以便将利尿剂正确用作该患者群体的靶向治疗药物。
