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“End‐stage kidney” in longstanding bulimia nervosa
Author(s) -
Yasuhara Daisuke,
Naruo Tetsuro,
Taguchi Shuhei,
Umekita Yoshihisa,
Yoshida Hiroki,
Nozoe Shinichi
Publication year - 2005
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.20198
Subject(s) - anorexia nervosa , bulimia nervosa , medicine , hypokalemia , renal biopsy , interstitial nephritis , renal function , gastroenterology , pathology , kidney , psychology , psychiatry , eating disorders
Objective The extent of renal damage over long‐term binge/purges has not been well documented in bulimia nervosa (BN). Method We describe a 52‐year‐old woman with longstanding BN subsequent to an 8‐year history of anorexia nervosa (AN). Results The patient showed chaotic binge/purges and chronic severe hypokalemia after recovery from AN at age 26 years, and renal biopsy showed juxtaglomerular hyperplasia, which was diagnosed as pseudo‐Bartter's syndrome. Discussion Over the following 26 years, the patient's eating behaviors remained chaotic, and her renal function gradually deteriorated. After the patient died of pneumonia and sepsis at age 52 years, autopsy of her kidney showed chronic interstitial nephritis, proximal tubular swelling, and diffuse glomerular sclerosis, suggesting chronic glomerular injury associated with long‐term binge/purges. To our knowledge, this is the first case report of a patient with BN with long‐term binge/purges who developed an eventual “end‐stage kidney” characterized by hypokalemic nephropathy and diffuse glomerulosclerosis. © 2005 by Wiley Periodicals, Inc. Int J Eat Disord 38: xxx–xxx, 2005.