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神经性厌食症的肾脏并发症。

Renal complications in anorexia nervosa.

作者信息

Stheneur Chantal, Bergeron Sebastien, Lapeyraque Anne-Laure

机构信息

Pediatrics Department, Adolescent Medicine Section, Sainte-Justine Hospital, 3175 Côte-Sainte-Catherine Road, Montreal, QC, H3T 1C5, Canada,

出版信息

Eat Weight Disord. 2014 Dec;19(4):455-60. doi: 10.1007/s40519-014-0138-z. Epub 2014 Jul 6.

Abstract

PURPOSE

Anorexia nervosa is a malady with possible long-lasting physiological consequences. Among these, little is known about the renal effects, which remain rarely investigated.

METHODS

A literature review was conducted using electronic databases and manual search of relevant articles, discussing the renal impacts of anorexia nervosa.

RESULTS

Renal failure has been described in malnourished patients, but the optimal non-invasive tool to assess the glomerular function rate in this population needs to be further evaluated. Significant disruptions in osmolar regulation, even in the absence of potomania, arise from multiple factors: hypothalamic dysfunction, intrinsic renal insufficiency, and use of psychotropic medications. Urinary urgency and nocturnal enuresis are frequent symptoms, rarely reported by patients. Among hydroelectrolytic disorders, hypokalemia is the most frequent, especially in settings of vomiting or medication misuse. Hyponatremia, hypomagnesemia, and hypophosphatemia may also be encountered. Urinary lithiases are relatively frequent as a consequence of dehydration, laxative use, or both.

CONCLUSION

Investigation and follow-up of the renal function are essential in patients with an eating disorder, especially when the illness has been present for a long time.

摘要

目的

神经性厌食症是一种可能会产生长期生理后果的疾病。其中,关于其对肾脏的影响知之甚少,相关研究也很少。

方法

通过电子数据库和手动检索相关文章进行文献综述,探讨神经性厌食症对肾脏的影响。

结果

营养不良患者中曾有肾衰竭的描述,但评估该人群肾小球滤过率的最佳非侵入性工具仍需进一步评估。即使没有水潴留性多尿症,渗透压调节也会因多种因素而出现显著紊乱:下丘脑功能障碍、内在肾功能不全以及使用精神药物。尿急和夜间遗尿是常见症状,但患者很少报告。在水电解质紊乱中,低钾血症最为常见,尤其是在呕吐或药物滥用的情况下。低钠血症、低镁血症和低磷血症也可能出现。由于脱水、使用泻药或两者兼而有之,尿路结石相对常见。

结论

对饮食失调患者进行肾功能检查和随访至关重要,尤其是在疾病长期存在的情况下。

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