| Abstract | Anoreksija nervoza (AN) je najčešći i najteži poremećaja jedenja kompleksne i još nepotpuno razjašnjene etiologije. Komplikacije AN su rezultat adaptacije metabolizma na ekstremnu pothranjenost i mogu dovesti i do smrti. Liječenje je kompleksno jednako kao i sama bolest, a sama hospitalizacija ukazuje na iznimno teško stanje oboljelog. Zbog velike važnosti za kliničku praksu, cilj je bio ispitati učestalost akutnih komplikacija s obzirom na endotip. Analizirani su podatci za 183 djevojčice i djevojke hospitalizirane zbog AN. Poremećaj acidobazne ravnoteže češći je kod bulimičko–purgativnog (BP) endotipa (25,3 % vs 16,7 %; p=0,003), dok je hiperfosfatemija učestalija kod restriktivnog (R) endotipa (21,7 % vs 17,2 %; p=0,009). Nešto viši pH krvi kod BP endotipa ukazuje na purgativne tehnike kojima pacijentice pribjegavaju. Hiperfosfatemija kod R endotipa je potvrđena kao čimbenik rizika za akutno zatajenje bubrega jer je praćena povećanim kreatininom (16/22 s hiperfosfatemijom), nižom idealnom tjelesnom masom (52,25 kg vs 55,22 kg; p=0,027), značajnijim gubitkom mase (18,41 % vs 22,64 %; p=0,031), nižim feritinom (p=0,021) te višim transferinom (p=0,020) i klorom (p=0,023). Pacijentice kojima su serumske razine kalcija, magnezija i/ili kalija povišene imaju niži pH krvi (7,39 vs 7,42; p<0,001) te veće vrijednosti kreatinina (81,50 vs 73,82 μmol; p=0,025) i ukupnih proteina (76,38 vs 74,36 g/L; p=0,039). Rezultati ukazuju na potrebu za pomnim praćenjem AN pacijenata kako bi se izbjegle metabolička alkaloza i akutno zatajenje bubrega. Ovi podaci su od iznimne važnosti kliničarima i jedinicama intenzivnog liječenja hospitaliziranih AN pacijenata. |
| Abstract (english) | Anorexia nervosa (AN) is the most common and the most severe eating disorder with a very complex and still incompletely understood etiology. AN complications result from metabolic adaptations of the body to extremely severe malnutrition and can even result with death. Treatments is as complex as the disease itself, and hospitalization emphasizes the severety of a patient. Due to immense importance for clinical practice, the aim was to analyse the prevalence of acute complications in different endotypes of AN. Data for 183 children and adolescents (all females) hospitalized due to AN were analyzed. Acid-base disorder was more common in binge-purging (BP) endotype (25.3 % vs 16.7 %; p=0.003), while hyperphosphatemia was more common in restrictive (R) endotype (21.7 % vs 17.2 %; p=0.009). Slightly higher blood pH in BP is indicative of pugrative techniques used by these patients. Hyperphosphatemia in R endotype was confirmed as a risk factor for acute kidney failure because it is accompanied by increased creatinin (16/22 with hyperphosphatemia), lower Ideal Body Weight (52.25 kg vs 55.22 kg; p=0.027), more significant weight loss (18.41 % vs 22.64 %; p=0.031), lower ferritin (p=0.021) and higher transferin (p=0.020) and chloride (p=0.023). Patients with elevated serum levels of calcium, magnesium and/or potassium have lower blood pH (7.39 vs 7.42; p<0.001) and higher creatinin (81.50 vs 73.82 μmol; p=0.025) and total proteins (76.38 vs 74.36 g/L; p=0.039). The results emphasize the need to closely monitor AN patients for metabolic alkalosis and acute kidney failure, making them very useful for clinicians and intensive clinical care for hospitalized AN patients. |
