Riva Anna, Pigni Maria, Nacinovich Renata
Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, Monza, Italy.
Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, Monza, Italy.
Clin Nutr ESPEN. 2021 Jun;43:230-234. doi: 10.1016/j.clnesp.2021.04.011. Epub 2021 Apr 24.
The alteration of kidney function in adolescents with anorexia nervosa (AN) is a frequent, but still poorly investigated, consequence of AN. In this study, we analyzed glomerular filtration rate with the Cockroft-Gault formula in a group of 148 adolescents with Anorexia Nervosa and correlated it to clinical and biochemical data collected at admission.
A retrospective study was conducted on 148 patients hospitalized from 2016 to 2019 for severe malnutrition due to restrictive AN. We measured glomerular filtration rate and correlated it with the patients' anamnestic history, nutritional status and biochemical data.
For the 148 AN patients, 40 (27%) resulted at admission at stage 1 of kidney damage (GFR>90 mL/min), 88 patients (59%) at stage 2 (GFR 89-60 mL/min), 17 patients (11%) at stage 3A (GFR 59-45 mL/min) and 3 patients (2%) at stage 3B (GFR 44-30 mL/min). Results outlined a correlation between the entity of kidney damage and BMI at admission and before illness onset, but not with the rapidity and entity of weight loss. Further, more severe renal damages corresponded to major biochemical and hormonal alterations.
Results of our study confirm that kidney damage is a frequent condition in adolescents with restrictive-type AN and support making kidney functionality tests part of routine care in patients with AN.
神经性厌食症(AN)青少年患者的肾功能改变是AN常见但仍未得到充分研究的后果。在本研究中,我们使用Cockcroft-Gault公式分析了148名神经性厌食症青少年患者的肾小球滤过率,并将其与入院时收集的临床和生化数据相关联。
对2016年至2019年因限制性AN导致严重营养不良而住院的148例患者进行回顾性研究。我们测量了肾小球滤过率,并将其与患者的既往病史、营养状况和生化数据相关联。
148例AN患者中,40例(27%)入院时处于肾损伤1期(肾小球滤过率>90 mL/分钟),88例(59%)处于2期(肾小球滤过率89-60 mL/分钟),17例(11%)处于3A期(肾小球滤过率59-45 mL/分钟),3例(2%)处于3B期(肾小球滤过率44-30 mL/分钟)。结果表明,肾损伤程度与入院时及发病前的体重指数相关,但与体重减轻的速度和程度无关。此外,更严重的肾损伤对应着更明显的生化和激素改变。
我们的研究结果证实,肾损伤在限制性AN青少年患者中很常见,并支持将肾功能测试作为AN患者常规护理的一部分。