Poor kidney graft survival in anorexia nervosa patients.

ABSTRACT

BACKGROUND: Anorexia nervosa is a condition associated with poor outcomes in a variety of circumstances such as recurrence of eating disorders, psychiatric disorders, and organ damage. OBJECTIVE: In the present study, we first sought to determine the 5-year kidney graft survival in patients with anorexia nervosa and then to evaluate the BMI course and medical complications. METHODS: In this multicenter, retrospective, case-control study, we analyzed the impact of anorexia nervosa on graft outcomes compared to transplant recipients with low or normal BMI. RESULTS: We enrolled 137 women in this study 19 with anorexia nervosa, 59 with low BMI (BMI < 18.5 kg/m2), and 59 with normal BMI (18.5-24.9 kg/m2). Anorexia nervosa was significantly associated with lower graft survival compared to either of the other groups (hazard ratio 5.5 [95% CI 3.4-8.9], p = 0.005); there was no difference in graft survival between patients with low or normal BMI. Cardiovascular complications were more frequent in the anorexia nervosa group (37%) than in patients with low (6%) or normal BMI (7%) (p = 0.001). CONCLUSION: We conclude that patients with anorexia nervosa should be considered a high-risk group. LEVEL OF EVIDENCE Level III, evidence obtained from well-designed cohort or case-control analytic studies.