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Estimation of renal function in patients with eating disorders
Fabio Fabbian1, Marco Pala, Giovanni Scanelli
1Department of Clinical and Experimental Medicine, University Hospital, St. Anna, Ferrara, Italy. f.fabbian@ospfe.it
The International Journal of Eating Disorders
|March 3, 2010
Summary
The Mayo Clinic Quadratic (MAYO) equation is a reliable tool for assessing renal function in patients with eating disorders, unlike the Cockcroft-Gault (C-G) or MDRD formulas, which show inaccuracies.
Area of Science:
- Nephrology
- Endocrinology
- Psychiatry
Background:
- Accurate assessment of renal function is crucial, especially in patients with eating disorders.
- Existing formulas like Cockcroft-Gault (C-G), Mayo Clinic Quadratic (MAYO), and MDRD have limitations in specific populations.
- Their clinical utility in severe energy restriction or obesity requires further investigation.
Purpose of the Study:
- To evaluate and compare the accuracy of different renal function estimation equations in patients with anorexia nervosa (AN) and bulimia nervosa (BN).
- To determine the most suitable equation for diagnosing renal insufficiency in individuals with eating disorders.
Main Methods:
- Renal function was assessed in 55 AN and 44 BN patients.
- Creatinine clearance was calculated using the C-G formula.
- Glomerular filtration rate (GFR) was estimated using the MAYO and MDRD equations.
Main Results:
- The BN group exhibited higher age, weight, BMI, and body surface area compared to the AN group.
- The AN group showed better renal function with MAYO and MDRD, but worse with C-G compared to the BN group.
- Bland-Altman analysis revealed poor correlation and disagreement among the three formulae.
Conclusions:
- The C-G formula is inaccurate for cachectic or obese individuals.
- The MDRD equation tends to underestimate renal function in cases of normal to high GFR.
- The MAYO equation appears to be a suitable alternative for accurately classifying renal function in patients with eating disorders.
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