The binge-purge syndrome: a common albeit unappreciated cause of acid-base and fluid-electrolyte disturbances.

The binge-purge syndrome (bulimarexia) is one of the four major eating disorders. It is a very important entity with which all clinicians should have some familiarity. This is true not only because of its frequency and the potential severity of several of its numerous complications, but because it has become one of the common masqueraders of modern medicine. Indeed, nephrologists may become interested in and involved with patients having this disorder because of their frequent fluid-electrolyte and acid-base disturbances, particularly hypokalemia and metabolic alkalosis, which initially often cause considerable diagnostic confusion. This paper presents an overall view of the binge-purge syndrome, with focus on several of its nephrologic aspects.