Laxative abuse, eating disorders, and kidney stones: a case report and review of the literature

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
David E LeafDavid S Goldfarb

Abstract

Kidney stones are listed among the complications of eating disorders; however, very few cases have been reported. We present an additional case of nephrolithiasis associated with laxative abuse, including detailed results of the patient's urine metabolic profiles, in a patient with idiopathic hypercalciuria. We review the literature and provide an explanation for the paucity of cases of nephrolithiasis associated with these disorders. Despite low urine volumes resulting from extracellular fluid volume depletion and hypocitraturia resulting from hypokalemia, both of which would tend to favor the formation of kidney stones, most patients with eating disorders are likely to be protected from stone formation by the hypocalciuric effect of extracellular fluid volume depletion and increased proximal tubular sodium reabsorption. However, patients with underlying idiopathic hypercalciuria who develop eating disorders may be at increased risk of stone formation in the setting of low urine volume and therefore high supersaturation of calcium oxalate and phosphate.

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Citations

Mar 26, 2013·AJR. American Journal of Roentgenology·Jessica J KraeftAlejandro M Heffess
Feb 16, 2016·The International Journal of Eating Disorders·K Jean ForneyGuido K W Frank
Nov 28, 2012·The Urologic Clinics of North America·Kristina L Penniston, Stephen Y Nakada
Feb 13, 2014·The Journal of Urology·Cynthia R SmithKhashayar Sakhaee
Jul 1, 2017·European Eating Disorders Review : the Journal of the Eating Disorders Association·Michelle R DenburgLawrence Copelovitch
Jan 11, 2018·Microscopy Research and Technique·Dalia S AshourMustafa M Abd Elnaby
Dec 4, 2019·Current Opinion in Nephrology and Hypertension·Lada Beara-Lasic, David S Goldfarb
Jul 3, 2017·CEN Case Reports·Nicholas ChadiKatherine Hick
Sep 4, 2019·Kidney & Blood Pressure Research·Marius SidlerCarsten A Wagner

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