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Stheneur C, Blanchet C, Mattar L, Dicembre M, Wilson K, Berthoz S, Hanachi M, Godart N. Determinants and risk factors for renal damage: where do patients hospitalized for severe anorexia nervosa stand? A multi-center study. J Eat Disord 2024; 12:72. [PMID: 38840178 PMCID: PMC11155155 DOI: 10.1186/s40337-024-01024-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/17/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Although renal damage is increasingly reported among the most undernourished patients with Anorexia Nervosa (AN), it remains underestimated in current practice, and often associated with acute dehydration. The purpose of our study was to evaluate the frequency, the extent, and the risk factors of renal involvement among adolescents and adults hospitalized in specialized units for AN. METHODS In this multi-center study, 197 consecutive participants were included, aged 13-65, from 11 inpatient eating disorder psychiatric units. Information on the course of AN, clinical characteristics, biological data, and medication were collected. RESULTS At admission, mean BMI was 13.1 (± 1.6) kg/m2 for a mean age of 20.74 (± 6.5) years and the z-score was - 3.6 (± 1.33). Six participants (3.0%) had hyponatremia, four (2.0%) had hypokalemia, and nine (4.5%) had hypochloremia. The Blood Urea Nitrogen/Creatinine ratio was over 20 for 21 (10.6%) participants. The mean plasma creatinine was 65.22 (± 12.8) µmol/L, and the mean eGFR was 74.74 (± 18.9) ml/min. Thirty- five participants (17.8%) had an eGFR > 90 ml/min, 123 (62.4%) from 60 to 90 ml/min, 35 (17.8%) from 45 to 60 ml/min, and 4 (2%) under 45 ml/min. In multivariate analysis, only BMI on admission was a determinant of renal impairment. The lower the BMI the more severe was the renal impairment. CONCLUSION When eGFR is calculated, it highlights renal dysfunction found in severe AN requiring hospitalisation in specialized units. The severity of undernutrition is an independent associated factor. Kidney functionality tests using eGFR, in addition to creatinine alone, should be part of routine care for patients with AN to detect underlying renal dysfunction.
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Affiliation(s)
- Chantal Stheneur
- University Center for Adolescent and Young Adult Health, Fondation Santé des Etudiants de France, 75014, Paris, France.
- CESP, INSERM, UMR 1018, University Paris-Sud, 94807, Villejuif Cedex, France.
- UVSQ, UFR Simone Veil, University Paris-Saclay, Montigny le Bretonneux, France.
| | - Corinne Blanchet
- CESP, INSERM, UMR 1018, University Paris-Sud, 94807, Villejuif Cedex, France
- Maison de Solenn-Maison des Adolescents, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France
| | - Lama Mattar
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Marika Dicembre
- Clinical Nutrition Unit, Paul Brousse University Hospital, Assistance Publique-Hôpitaux de Paris, Villejuif, France
| | - Kayigan Wilson
- University Center for Adolescent and Young Adult Health, Fondation Santé des Etudiants de France, 75014, Paris, France
| | - Sylvie Berthoz
- Univ. Bordeaux, INCIA CNRS UMR5287, 33000, Bordeaux, France
- Department of Psychiatry, Institut Mutualiste Montsouris, 75014, Paris, France
| | - Mouna Hanachi
- Clinical Nutrition Unit, Paul Brousse University Hospital, Assistance Publique-Hôpitaux de Paris, Villejuif, France
- Paris-Saclay University, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, France
| | - Nathalie Godart
- University Center for Adolescent and Young Adult Health, Fondation Santé des Etudiants de France, 75014, Paris, France
- CESP, INSERM, UMR 1018, University Paris-Sud, 94807, Villejuif Cedex, France
- UVSQ, UFR Simone Veil, University Paris-Saclay, Montigny le Bretonneux, France
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Dehghan M, Tantbirojn D, Harrison J, Stewart CW, Johnson N, Tolley EA, Zhang YH. Oral Health and Behavior Patterns of Women with Eating Disorders-A Clinical Pilot Study. Life (Basel) 2023; 13:2297. [PMID: 38137898 PMCID: PMC10744595 DOI: 10.3390/life13122297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Chronic stomach regurgitation associated with eating disorders (EDs) poses a high risk for tooth erosion. This study investigated oral health conditions, behavioral patterns, and tooth erosion in women with EDs. METHODS 16 ED and 13 healthy women were enrolled; 14 ED and 10 healthy control subjects completed the study. Subjects completed demographic, medical, oral, and behavioral health history questionnaires. Dental caries status was recorded as Decayed, Missing and Filled Teeth (DMFT)index and the severity of tooth erosion as Basic Erosive Wear Examination (BEWE) scores. Saliva was collected for flow rate, pH, and buffering capacity analysis. RESULTS The ED group had a lower stimulated saliva flow rate and higher DMFT index but no significant difference in BEWE scores compared to the controls (t-test, significance level 0.05). Five of the fourteen ED subjects exhibited extensive tooth erosion, which may have been exacerbated by their tooth-brushing behavior. CONCLUSIONS Although some ED subjects showed extensive tooth erosion in this pilot study, the average BEWE score of the ED group was not significantly different from the controls. Extensive tooth erosion in ED may relate to the low stimulated salivary flow. A larger-scale clinical study is necessary to validate these results.
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Affiliation(s)
- Mojdeh Dehghan
- College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA
| | - Daranee Tantbirojn
- Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA
| | - Janet Harrison
- Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA
| | - Colette W. Stewart
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA
| | - Nancy Johnson
- Transformation Center, 1088 Rogers Road, Cordova, TN 38018, USA
| | - Elizabeth A. Tolley
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, 66 N Pauline, Memphis, TN 38163, USA
| | - Yanhui H. Zhang
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA
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