Two cases of eating disorder revealed by the breakout of acute kidney injury after angiotensin II receptor blocker administration

CEN Case Reports
Shuzo Kaneko, Yusuke Tsukamoto

Abstract

Case 1: A 39-year-old woman with schizophrenia, obesity, hypertension and dyslipidemia was admitted to our hospital for deteriorating serum Cr level, from 97.2 to 645.3 µmol/l. She had been started on losartan 5 months earlier. After suspension of losartan and infusion of saline, her serum Cr level gradually recovered and she was discharged. Unfortunately, her physician restarted her on losartan, and 5 months after this discharge, her serum Cr level rose again to 194.5 μmol/l; again, serum Cr promptly recovered when losartan was discontinued. Self-induced vomiting after overeating, suggesting bulimia nervosa, was revealed via the detection of a remarkable reduction of chloride compared to sodium in her spot-urine sample. Case 2: A 39-year-old woman who had been diagnosed with bipolar disorder and diabetes mellitus was admitted to our hospital with suspected diabetic ketoacidosis. After improvement in her blood sugar level, olmesartan administration for hypertension was begun. Four days later, her serum Cr level had risen from 60.1 to 256.4 μmol/l. After suspension of olmesartan and infusion of saline, her serum Cr level gradually fell to normal levels. Urinalysis revealed the dissociation of sodium and chloride. During her hosp...Continue Reading

References

Mar 1, 1978·Acta paediatrica Scandinavica·A AperiaL Fohlin
Dec 1, 1992·Acta Psychiatrica Scandinavica·O MizunoT Nakagawa
Sep 15, 1993·Biological Psychiatry·O MizunoT Nakagawa
Mar 17, 2004·Eating and Weight Disorders : EWD·L M Jonat, C L Birmingham
Oct 19, 2005·The International Journal of Eating Disorders·Daisuke YasuharaShin-ichi Nozoe
May 4, 2006·American Journal of Physiology. Renal Physiology·Jill W VerlanderSusan M Wall
Jul 1, 2006·Eating and Weight Disorders : EWD·S TakakuraC Kubo
Dec 3, 2011·Nephron. Clinical Practice·Gioacchino Li CavoliUgo Rotolo

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