Arch Gen Intern Med 2018 Volume 2 Issue 1 1 http://www.alliedacademies.org/archives-of-general-internal-medicine/ Research Article Purpose: Renal complications are classically described in anorexia nervosa (AN). Our aim was to study the initial renal function and its outcome after refeeding in a population of female adolescents hospitalized for AN, and to look for predictive factors of the development of renal failure. Methods: Renal function was assessed using the Cockcroft and Gault formula before and after the refeeding period in 106 inpatient AN girls in an adolescent medical unit. Predictive factors for renal impairment and potential for recovery were sought using patient anamnestic, anthropometric and biological characteristics. Results: Creatinine clearance was reduced at admission, and improved signiicantly at discharge (63.9 mL/min vs. 84.2 mL/min, p<0.01). Only 4 patients presented an initial normal renal function, 58 a mild reduction, and 44 a moderate reduction. At discharge, these igures were respectively 40, 56 and 10. The positive predictive factors identiied were BMI (r=0.22; p=0.02), weight gain (r=0.64; p<0.01) and potassium levels at admission (r=0.23, p=0.02). No differences were observed for creatinine clearance levels at admission between restrictive (ANR) and binge/ purging (ANBP) patients, but clearance rates at discharge among ANR were statistically better (87.7 mL/min vs. 75.8 mL/min, p<0.01). Conclusion: Impairment of renal function in hospitalized anorexic adolescents may be transient or persistent after refeeding depending of initial malnutrition severity and nutritional status at the time of discharge. It seems essential not to under-diagnose the persistence of renal function deiciency following the refeeding phase, in order to limit the risk of severe renal impairment or end-stage renal disease in adulthood. Abstract Introduction Anorexia Nervosa (AN) is a very serious eating disorder with various somatic complications affecting somato-nutritional, psycho-social and family spheres. Patients may present a restrictive type (ANR) or a binge/purging type (ANBP) deined by DSM5 criteria [1]. The illness generally lasts two to ive years with evolving symptoms and diagnostic instability. In 50% of cases, AN crosses over to another eating disorder subtype especially to bulimia or non-speciic eating disorders [2]. Recovery rates range from 30 to 80% according to the criteria used [3] [4]. However comorbidities and mortality are far from negligible. In their meta-analysis, Arcelus et al., reported a death rate of 0.51% of patients per year, from suicide in one in ive cases [5]. Concerning somatic comorbidities, the renal complications are not well known, under-estimated and under-investigated while they can be dramatic [6]. According to Brotman et al., 70% of the patients with AN will encounter renal complications in the course of their illness, amounting to a prevalence ive times greater than in the general population [7]. The study by Zipfel et al., for its part, describes a rate of terminal renal failure necessitating hemodialysis in 5% of patients in a cohort of 84 patients followed for 21 years. This information is all the more worrying because the mean age of these patients at the end of follow-up was only 42 [8]. The main disturbances observed are electrolyte disorders of the hypokalemic type, hyponatremia or magnesium deiciency can also be cited, along with phosphorus deiciency [9-11]. Patients also present renal lithiasis for 5% [12], and nephrocalcinosis [13,14]. Episodes of acute renal failure resulting from hypovolemia or rhadomyolysis (linked to reduced phosphorus and calcium levels and intense hyperactivity) are not uncommon. The state of relative immuno- depression of these patients favors the onset of urine infections [15]. Various studies have explored the repercussions of these different anomalies on renal function. Thus Delanaye et al. reported that 33% of their patients presented a Glomerular Filtration Rate (GFR) below 60 mL/min [16]. In a case-control comparative study, the anorexic patients had a signiicantly lower GFR than the controls [17]. Fohlin et al. and Russel et al. obtained similar results [18,19]. These impairments do however appear to be reversible with weight gain. Thus 9 out of 10 patients in the study by Boag et al. exhibited a signiicant decrease in creatinemia and an improvement in clearance rates in the course of refeeding [20]. These results are coherent with those of Russel et al. [19]. There are very little data on renal function in adolescent anorexic populations. The main aim of the present study was Renal function outcome in hospitalized adolescent girls with anorexia nervosa. Mathilde Mignot-Bedetti 1,2 , Marie Rose Moro 1,2 , Corinne Blanchet-Collet 1,2* 1 Maison de Solenn-Maison des Adolescents-Cochin Hospital, AP-HP, 75014, Paris, France 2 CESP, INSERM 1178, Paris-Descartes University, USPC, Paris, France Accepted on January 06, 2018 Keywords: Anorexia nervosa, Adolescents, Renal function, Hypokalemia, Malnutrition, Refeeding.