engleski

Acute Complications in Children and Adolescents with Restrictive Anorexia Nervosa

Anorexia nervosa (AN) is the most common and the most severe eating disorder with a very complex, and still incompletely understood etiology. AN complications result from metabolic adaptations of the body to extremely severe malnutrition and can even result with death. Treatments is as complex as the disease itself, and hospitalization emphasizes the severety of a patient. The aim was to analyse the prevalence of acute complications in different endotypes of AN. Data for 183 children and adolescents (all females) hospitalized due to AN were analyzed. Acid-base disorder was more common in binge- purging (BP) endotype (25.3 % vs 16.7 % ; p=0.003), while hyperphosphatemia was more common in restrictive (R) endotype (21.7 % vs 17.2 % ; p=0.009). Slightly higher blood pH in BP is indicative of pugrative techniques used by these patients. Hyperphosphatemia in R endotype was confirmed as a risk factor for acute kidney failure due to increased creatinin levels (16/22 with hyperphosphatemia), lower Ideal Body Weight (52.25 kg vs 55.22 kg ; p=0.027), more significant weight loss (18.41 % vs 22.64 % ; p=0.031), lower ferritin (p=0.021) and higher transferin (p=0.020) and chloride (p=0.023). Patients with elevated serum levels of calcium, magnesium and/or potassium have lower blood pH (7.39 vs 7.42 ; p<0.001) and higher creatinin (81.50 vs 73.82 µmol ; p=0.025) and total proteins (76.38 vs 74.36 g/L ; p=0.039). Presented results are of great importance to clinicians and ICU staff, indicating high prevalence and risk of metabolic alkalosis and acute kidney failure in hospitalized AN patients.

Anorexia nervosa ; acute complications ; acid-base disorders ; restrictive entotype ; purgative endotype

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