Kidney Damage And Renal Failure: Long Term Side Effects Of Eating Disorders?

People whose eating disorders cause them to purge themselves often develop kidney disease. Experts note that over 70 percent of people who live with anorexia have kidney complications, and about five percent will die of kidney disease before the age of 45. Up to 20 percent of people who have anorexia remain chronically ill for the rest of their lives.

Kidney disease is less frequent and less severe in people who have eating disorders but do not purge, that is, they do not try to get rid of calories through self-induced vomiting or using laxatives and/or diuretics. People who live with binge eating disorder do not have an increased risk of kidney disease related to their eating disorder other than type 2 diabetes. However, in people who purge, these nine conditions are unfortunately common.

Acute kidney injury

The mechanical force of violent vomiting or diarrhea breaks down tissue and red blood cells. The fragments and chemical byproducts of this tissue breakdown can trigger kidney failure. Signs that vomiting or diarrhea may have caused kidney failure requiring emergency medical care include unexplained dehydration, swollen feet and hands, and passing blood.

Alkalosis

In metabolic alkalosis, the kidneys are unable to keep the bloodstream acid enough. The underlying cause of this problem usually is the loss of stomach acid through vomiting. With this disturbance of pH, a variety of symptoms may follow:

• Vague symptoms such as fatigue, muscle pain, and frequent urination.
• Muscle spasms, tingling around the mouth, and jitteriness (due to loss of calcium).
• Slow and shallow breathing, due to the effects of electrolyte depletion on the brain.
• Cardiac arrhythmias.

All of these symptoms are made worse by the use of diuretics. They are also aggravated by use of tobacco products (especially chewing tobacco), eating licorice, or taking steroids.

Edema

About 20 percent of people who live with anorexia nervosa or bulimia develop the swelling known as edema. It can be caused by lack of protein in the diet, or by electrolyte disturbances that affect the kidneys.

Hypokalemic nephropathy

Between 15 and 20 percent of people who have anorexia nervosa develop hypokalemic nephropathy. Tis is a condition of chronic kidney damage caused by low potassium levels, low chloride levels, and dehydration. When the kidneys are deprived of these two electrolytes, they produce excessive amounts of a hormone called angiotensin. This increases blood pressure, which forces more blood through the kidneys, which results in more urination. Urination depletes the body of potassium and chloride, causing a vicious cycle. People who develop hypokalemic nephropathy have to go to the bathroom a lot but they also become constipated. They usually develop salt cravings. Giving in to the salt cravings makes the condition still worse. There will be fatigue, muscle weakness, and cramps in the feet.

Hyponatremia

The most common electrolyte imbalance in people who have anorexia or bulimia who purge is hyponatremia, low bloodstream sodium levels. Chronically undernourished kidneys cannot retain the limited amount of sodium coming from the diet, and bloodstream levels of sodium fall. Symptoms of hyponatremia include confusion, fatigue, headache, nausea and vomiting, cramps, weakness, and seizures.

Hypernatremia

In rare cases, anorexia results in hypernatremia, the opposite of hyponatremia. Hypernatremia is a condition of unusually high sodium levels in the blood stream. It can be difficult to distinguish the symptoms of hypernatremia from the effects of the eating disorder. Both conditions cause lethargy. Both conditions are associated with general weakness. However, hypernatremia also results in rapid pulse, muscle twitches, dry mouth, dry skin, and “drifting off” (obtundation). The underlying problem in eating disorders that causes hypernatremia is not getting enough fluid. The kidneys can’t regulate sodium levels when the body is dehydrated.

Kidney stones

People who have anorexia, bulimia, and EDNOS are at added risk for kidney stones for two reasons. Their diets are deficient in magnesium, which helps prevent the formation of stones, and they tend to become dehydrated. When people are dehydrated, the lack of frequent urination allows crystals to grow into gravel and stones. Not everyone who has an eating disorder develops kidney stones, but an eating disorder will aggravate other tendencies for the disease.

Refeeding syndrome

Restarting food intake too quickly can result in severe electrolyte disturbances and even death. It is important to keep calorie intake in line with the body’s basic needs for the first several days following starvation. In refeeding syndrome, the kidneys are unable to retain potassium, magnesium, and phosphate, or keep up with the amount of water consumed.

Repeated urinary tract infections

Passing kidney stones and kidney gravel cuts the lining of the urinary tract. Chronic dehydration keeps urine in contact with these tiny cuts and abrasions. When a microorganism that causes urinary tract infection finds its way into the urinary tract, chronic infections are likely.