Anorexia Nervosa and the Kidney

Anorexia Nervosa - Trina Banerjee Metabolic Abnormalities of Anorexia Etiologies of Kidney Failure Treatment Hypokalemia Hyponatremia

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Unformatted text preview: Trina Banerjee ¡ Metabolic Abnormalities of Anorexia ¡ Etiologies of Kidney Failure ¡ Treatment ¡ Hypokalemia ¡ Hyponatremia ¡ Hypercalcemia ¡ Hypomagnesemia ¡ Hypophosphatemia ¡ Metabolic Acidosis ¡ Decreased Reabsorption of K: ¢ K is reabsorbed using the H/K ATPase, which requires an acceptor for the proton in the tubular fluid ¢ In anorexia the phosphate stores are low and bicarb will have been reabsorbed proximally ¡ Increased Secretion of K: ¢ Decreased effective circulating volume results in an increase in aldosterone ¡ Impaired urinary concentration: ¢ Decreased collecting system responsiveness to ADH, with decreased expression of aquaporin-2, when K<3 meq/L ¡ Increased renal ammonia production: ¢ As K leaves the tubular cell H enters, causing intracellular acidosis ¢ The H is then secreted leading to increased ammonia formation ¡ Low solute ingestion ¡ Impaired Osmoregulation ¡ Case control study ¡ 12 patients with anorexia, 10 on antidepressants. 2 control groups: 12 women without anorexia not on antidepressants and 11 women on antidepressants ¡ Urine osmolarity measured at baseline and after 12 hour fast ¡ Compared to women not on antidepressants, anorexics had: ¢ Baseline: Identical urine urea and creatinine, identical serum ADH, higher baseline osmolarities ¢ Following water deprivation: Minimal increase in ADH, minimal rise in urine osmolarity ¡ Increased bone breakdown from acidosis, results in hypercalciuria ¡ High calcium turns oiff the calcium sensing receptor in the thick ascending tubule shutting off ROM-K, leading to magnesium wasting ¡...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Anorexia Nervosa - Trina Banerjee Metabolic Abnormalities of Anorexia Etiologies of Kidney Failure Treatment Hypokalemia Hyponatremia

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