Risk of dialysis and renal diseases in patients with anorexia nervosa in Taiwan
Objective To investigate the incidence and risk of renal‐related complications in a nationwide cohort of Taiwanese patients with anorexia nervosa (AN). Method This longitudinal cohort study analyzed the data of 43,951 individuals—comprising 2091 patients with AN and their controls matched (1:20) usi...
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| Veröffentlicht in: | The International journal of eating disorders 2023-05, Vol.56 (5), p.991-1000 |
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| container_title | The International journal of eating disorders |
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| creator | Tseng, Mei‐Chih Meg Chien, Li‐Nien Tu, Chao‐Ying Zheng, Cai‐Mei Liu, Hung‐Yi |
| description | Objective
To investigate the incidence and risk of renal‐related complications in a nationwide cohort of Taiwanese patients with anorexia nervosa (AN).
Method
This longitudinal cohort study analyzed the data of 43,951 individuals—comprising 2091 patients with AN and their controls matched (1:20) using propensity scores according to sex, age, degree of urbanization of residence, socioeconomic status, and year of diagnosis—from a population‐based health insurance database; the study lasted 16 years. We used Kaplan–Meier curves to estimate the cumulative incidence of renal events. We also performed Cox proportional regression and constructed a risk model with death as a competing event (both adjusted for basic characteristics, renal diseases, and psychiatric comorbidities) to examine the risk of dialysis and renal outcomes in the AN group relative to the control group.
Results
In total, 204 and 10 patients with AN had renal‐related outcomes and end‐stage renal disease (ESRD), respectively. The cumulative incidence rates of all renal outcomes and ESRD in the AN group were 10.72% and .64%, respectively, at 10‐year follow‐up. Compared with the control group, the AN group had a significantly higher risk of acute dialysis (adjusted hazard ratio 2.10 [95% confidence interval 1.19–3.68]), hypokalemia, hypovolemia, nephritis, acute renal failure, and chronic renal failure. The AN group did not have a significantly higher risk of ESRD.
Discussion
The elevated risks of acute dialysis and some renal outcomes in AN highlight the importance of monitoring electrolyte imbalance and renal malfunctioning.
Public Significance
Malnutrition and purging behaviors may cause renal complications in patients with AN. In this longitudinal cohort study, we found that the 10‐year cumulative incidence of all renal outcomes in AN was 10.72%, and that patients with AN had a two‐fold higher risk of overall renal outcomes compared with those without AN. Our findings imply that weight restoration and ceasing purging behaviors are crucial for recovery from AN. |
| doi_str_mv | 10.1002/eat.23899 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2768233044</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2808174614</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-5470a9e6c8070fa40edbe6b457c9529009ea08bfb6e1a0f94ddc07542922fc283</originalsourceid><addsrcrecordid>eNp10E9Lw0AQBfBFFFurB7-ABLzoIXWyu0l2j6XUPyAUpIK3MEkmuJomdTe19tu7NepB8DQw_HjwHmOnEYwjAH5F2I25UFrvsWEEWoURqKd9NgSeJqGQqRqwI-deACAREB-ygUgSBVLHQzZ_MO41aKugNFhvnXEBNmVgqcHavxyhIxeYJlhhZ6jpXLAx3bM3raUPg0FD9r11uBMLNBtsjtlBhbWjk-87Yo_Xs8X0Nryf39xNJ_dhIWKhw1imgJqSQkEKFUqgMqckl3Fa6JhrAE0IKq_yhCKESsuyLCCNJdecVwVXYsQu-tyVbd_W5LpsaVxBdY0NtWuX-eaKCwFSenr-h760a-sLeqVARalMop267FVhW-csVdnKmiXabRZBtls58ytnXyt7e_aduM6XVP7Kn1k9uOrBxtS0_T8pm00WfeQn8XyFTw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2808174614</pqid></control><display><type>article</type><title>Risk of dialysis and renal diseases in patients with anorexia nervosa in Taiwan</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Tseng, Mei‐Chih Meg ; Chien, Li‐Nien ; Tu, Chao‐Ying ; Zheng, Cai‐Mei ; Liu, Hung‐Yi</creator><creatorcontrib>Tseng, Mei‐Chih Meg ; Chien, Li‐Nien ; Tu, Chao‐Ying ; Zheng, Cai‐Mei ; Liu, Hung‐Yi</creatorcontrib><description>Objective
To investigate the incidence and risk of renal‐related complications in a nationwide cohort of Taiwanese patients with anorexia nervosa (AN).
Method
This longitudinal cohort study analyzed the data of 43,951 individuals—comprising 2091 patients with AN and their controls matched (1:20) using propensity scores according to sex, age, degree of urbanization of residence, socioeconomic status, and year of diagnosis—from a population‐based health insurance database; the study lasted 16 years. We used Kaplan–Meier curves to estimate the cumulative incidence of renal events. We also performed Cox proportional regression and constructed a risk model with death as a competing event (both adjusted for basic characteristics, renal diseases, and psychiatric comorbidities) to examine the risk of dialysis and renal outcomes in the AN group relative to the control group.
Results
In total, 204 and 10 patients with AN had renal‐related outcomes and end‐stage renal disease (ESRD), respectively. The cumulative incidence rates of all renal outcomes and ESRD in the AN group were 10.72% and .64%, respectively, at 10‐year follow‐up. Compared with the control group, the AN group had a significantly higher risk of acute dialysis (adjusted hazard ratio 2.10 [95% confidence interval 1.19–3.68]), hypokalemia, hypovolemia, nephritis, acute renal failure, and chronic renal failure. The AN group did not have a significantly higher risk of ESRD.
Discussion
The elevated risks of acute dialysis and some renal outcomes in AN highlight the importance of monitoring electrolyte imbalance and renal malfunctioning.
Public Significance
Malnutrition and purging behaviors may cause renal complications in patients with AN. In this longitudinal cohort study, we found that the 10‐year cumulative incidence of all renal outcomes in AN was 10.72%, and that patients with AN had a two‐fold higher risk of overall renal outcomes compared with those without AN. Our findings imply that weight restoration and ceasing purging behaviors are crucial for recovery from AN.</description><identifier>ISSN: 0276-3478</identifier><identifier>EISSN: 1098-108X</identifier><identifier>DOI: 10.1002/eat.23899</identifier><identifier>PMID: 36680495</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Anorexia ; Anorexia Nervosa - complications ; Cohort analysis ; dialysis ; Eating disorders ; end‐stage ; Hemodialysis ; Humans ; hypokalemia ; Incidence ; Kidney diseases ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - epidemiology ; Longitudinal Studies ; registered study ; Renal Dialysis - adverse effects ; renal disease ; renal diseaseanorexia nervosa ; Retrospective Studies ; Risk Factors ; Taiwan - epidemiology</subject><ispartof>The International journal of eating disorders, 2023-05, Vol.56 (5), p.991-1000</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-5470a9e6c8070fa40edbe6b457c9529009ea08bfb6e1a0f94ddc07542922fc283</citedby><cites>FETCH-LOGICAL-c3539-5470a9e6c8070fa40edbe6b457c9529009ea08bfb6e1a0f94ddc07542922fc283</cites><orcidid>0000-0002-0114-102X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Feat.23899$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Feat.23899$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36680495$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tseng, Mei‐Chih Meg</creatorcontrib><creatorcontrib>Chien, Li‐Nien</creatorcontrib><creatorcontrib>Tu, Chao‐Ying</creatorcontrib><creatorcontrib>Zheng, Cai‐Mei</creatorcontrib><creatorcontrib>Liu, Hung‐Yi</creatorcontrib><title>Risk of dialysis and renal diseases in patients with anorexia nervosa in Taiwan</title><title>The International journal of eating disorders</title><addtitle>Int J Eat Disord</addtitle><description>Objective
To investigate the incidence and risk of renal‐related complications in a nationwide cohort of Taiwanese patients with anorexia nervosa (AN).
Method
This longitudinal cohort study analyzed the data of 43,951 individuals—comprising 2091 patients with AN and their controls matched (1:20) using propensity scores according to sex, age, degree of urbanization of residence, socioeconomic status, and year of diagnosis—from a population‐based health insurance database; the study lasted 16 years. We used Kaplan–Meier curves to estimate the cumulative incidence of renal events. We also performed Cox proportional regression and constructed a risk model with death as a competing event (both adjusted for basic characteristics, renal diseases, and psychiatric comorbidities) to examine the risk of dialysis and renal outcomes in the AN group relative to the control group.
Results
In total, 204 and 10 patients with AN had renal‐related outcomes and end‐stage renal disease (ESRD), respectively. The cumulative incidence rates of all renal outcomes and ESRD in the AN group were 10.72% and .64%, respectively, at 10‐year follow‐up. Compared with the control group, the AN group had a significantly higher risk of acute dialysis (adjusted hazard ratio 2.10 [95% confidence interval 1.19–3.68]), hypokalemia, hypovolemia, nephritis, acute renal failure, and chronic renal failure. The AN group did not have a significantly higher risk of ESRD.
Discussion
The elevated risks of acute dialysis and some renal outcomes in AN highlight the importance of monitoring electrolyte imbalance and renal malfunctioning.
Public Significance
Malnutrition and purging behaviors may cause renal complications in patients with AN. In this longitudinal cohort study, we found that the 10‐year cumulative incidence of all renal outcomes in AN was 10.72%, and that patients with AN had a two‐fold higher risk of overall renal outcomes compared with those without AN. Our findings imply that weight restoration and ceasing purging behaviors are crucial for recovery from AN.</description><subject>Anorexia</subject><subject>Anorexia Nervosa - complications</subject><subject>Cohort analysis</subject><subject>dialysis</subject><subject>Eating disorders</subject><subject>end‐stage</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>hypokalemia</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Longitudinal Studies</subject><subject>registered study</subject><subject>Renal Dialysis - adverse effects</subject><subject>renal disease</subject><subject>renal diseaseanorexia nervosa</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Taiwan - epidemiology</subject><issn>0276-3478</issn><issn>1098-108X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10E9Lw0AQBfBFFFurB7-ABLzoIXWyu0l2j6XUPyAUpIK3MEkmuJomdTe19tu7NepB8DQw_HjwHmOnEYwjAH5F2I25UFrvsWEEWoURqKd9NgSeJqGQqRqwI-deACAREB-ygUgSBVLHQzZ_MO41aKugNFhvnXEBNmVgqcHavxyhIxeYJlhhZ6jpXLAx3bM3raUPg0FD9r11uBMLNBtsjtlBhbWjk-87Yo_Xs8X0Nryf39xNJ_dhIWKhw1imgJqSQkEKFUqgMqckl3Fa6JhrAE0IKq_yhCKESsuyLCCNJdecVwVXYsQu-tyVbd_W5LpsaVxBdY0NtWuX-eaKCwFSenr-h760a-sLeqVARalMop267FVhW-csVdnKmiXabRZBtls58ytnXyt7e_aduM6XVP7Kn1k9uOrBxtS0_T8pm00WfeQn8XyFTw</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Tseng, Mei‐Chih Meg</creator><creator>Chien, Li‐Nien</creator><creator>Tu, Chao‐Ying</creator><creator>Zheng, Cai‐Mei</creator><creator>Liu, Hung‐Yi</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0114-102X</orcidid></search><sort><creationdate>202305</creationdate><title>Risk of dialysis and renal diseases in patients with anorexia nervosa in Taiwan</title><author>Tseng, Mei‐Chih Meg ; Chien, Li‐Nien ; Tu, Chao‐Ying ; Zheng, Cai‐Mei ; Liu, Hung‐Yi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-5470a9e6c8070fa40edbe6b457c9529009ea08bfb6e1a0f94ddc07542922fc283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anorexia</topic><topic>Anorexia Nervosa - complications</topic><topic>Cohort analysis</topic><topic>dialysis</topic><topic>Eating disorders</topic><topic>end‐stage</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>hypokalemia</topic><topic>Incidence</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Longitudinal Studies</topic><topic>registered study</topic><topic>Renal Dialysis - adverse effects</topic><topic>renal disease</topic><topic>renal diseaseanorexia nervosa</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Taiwan - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tseng, Mei‐Chih Meg</creatorcontrib><creatorcontrib>Chien, Li‐Nien</creatorcontrib><creatorcontrib>Tu, Chao‐Ying</creatorcontrib><creatorcontrib>Zheng, Cai‐Mei</creatorcontrib><creatorcontrib>Liu, Hung‐Yi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The International journal of eating disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tseng, Mei‐Chih Meg</au><au>Chien, Li‐Nien</au><au>Tu, Chao‐Ying</au><au>Zheng, Cai‐Mei</au><au>Liu, Hung‐Yi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of dialysis and renal diseases in patients with anorexia nervosa in Taiwan</atitle><jtitle>The International journal of eating disorders</jtitle><addtitle>Int J Eat Disord</addtitle><date>2023-05</date><risdate>2023</risdate><volume>56</volume><issue>5</issue><spage>991</spage><epage>1000</epage><pages>991-1000</pages><issn>0276-3478</issn><eissn>1098-108X</eissn><abstract>Objective
To investigate the incidence and risk of renal‐related complications in a nationwide cohort of Taiwanese patients with anorexia nervosa (AN).
Method
This longitudinal cohort study analyzed the data of 43,951 individuals—comprising 2091 patients with AN and their controls matched (1:20) using propensity scores according to sex, age, degree of urbanization of residence, socioeconomic status, and year of diagnosis—from a population‐based health insurance database; the study lasted 16 years. We used Kaplan–Meier curves to estimate the cumulative incidence of renal events. We also performed Cox proportional regression and constructed a risk model with death as a competing event (both adjusted for basic characteristics, renal diseases, and psychiatric comorbidities) to examine the risk of dialysis and renal outcomes in the AN group relative to the control group.
Results
In total, 204 and 10 patients with AN had renal‐related outcomes and end‐stage renal disease (ESRD), respectively. The cumulative incidence rates of all renal outcomes and ESRD in the AN group were 10.72% and .64%, respectively, at 10‐year follow‐up. Compared with the control group, the AN group had a significantly higher risk of acute dialysis (adjusted hazard ratio 2.10 [95% confidence interval 1.19–3.68]), hypokalemia, hypovolemia, nephritis, acute renal failure, and chronic renal failure. The AN group did not have a significantly higher risk of ESRD.
Discussion
The elevated risks of acute dialysis and some renal outcomes in AN highlight the importance of monitoring electrolyte imbalance and renal malfunctioning.
Public Significance
Malnutrition and purging behaviors may cause renal complications in patients with AN. In this longitudinal cohort study, we found that the 10‐year cumulative incidence of all renal outcomes in AN was 10.72%, and that patients with AN had a two‐fold higher risk of overall renal outcomes compared with those without AN. Our findings imply that weight restoration and ceasing purging behaviors are crucial for recovery from AN.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36680495</pmid><doi>10.1002/eat.23899</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0114-102X</orcidid></addata></record> |
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| ispartof | The International journal of eating disorders, 2023-05, Vol.56 (5), p.991-1000 |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Anorexia Anorexia Nervosa - complications Cohort analysis dialysis Eating disorders end‐stage Hemodialysis Humans hypokalemia Incidence Kidney diseases Kidney Failure, Chronic - complications Kidney Failure, Chronic - epidemiology Longitudinal Studies registered study Renal Dialysis - adverse effects renal disease renal diseaseanorexia nervosa Retrospective Studies Risk Factors Taiwan - epidemiology |
| title | Risk of dialysis and renal diseases in patients with anorexia nervosa in Taiwan |
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