Electrolyte imbalances in individuals with eating disorder may increase mortality risk, reveals study

The results of a new study published in The Lancet Psychiatry journal highlighted the need for routinely checking electrolyte levels in individuals with eating disorders and acting quickly to address any abnormalities discovered in order to lower the risk of complications and early death.

Eating disorders (ED) have a significant role in extensive organ failure, including kidney function issues. Abnormal kidney function and electrolyte abnormalities are common in ED patients, involving chronic kidney disease (CKD) and acute kidney injury (AKI), which are most commonly associated with persistent hypokalaemia and volume depletion. Electrolyte imbalances are more common in individuals with eating disorder than in the general population. This study was carried out by Marco Solmi and team to determine if electrolyte imbalances in individuals with eating disorder were linked to physical health outcomes and death.

In Ontario, individuals who were 13 years of age or older who had an eating disorder and had an outpatient electrolyte measure within a year (between January 1, 2008 and June 30, 2019) were included in this retrospective population-based cohort research. Hypokalaemia, hyperkalaemia, hypernatraemia, hyponatraemia, hypomagnesaemia, metabolic acidosis, hypophosphataemia, or metabolic alkalosis were all considered electrolyte abnormalities. Death from all causes was the main outcome. Hospitalization, a cardiac episode, infection, acute or chronic renal illness, fracture, and bowel obstruction were the secondary outcomes. This study also looked at a younger cohort (less than 25 years old) and people who had no secondary outcome diagnosis prior to this.

A total of 6163 patients with an eating disorder and an electrolyte measure within a year of diagnosis were included. The study found no accessible ethnicity statistics. Hypokalaemia (994/1987 [50·0%]), hyponatraemia (752/1987 [37·8%]), and hypernatraemia (420/1987 [21·1%]) were the most prevalent electrolyte abnormalities. In all, 234/4176 (5·6%) of individuals without an electrolyte abnormality and 311/1987 (15·7%) of the ones with one experienced fatality.

An electrolyte imbalance was linked to hospitalization, acute renal damage, chronic kidney disease, bone fracture, and bowel obstruction, but not to infection or a cardiovascular event. The results were similar across eating disorder types, sexes, and young people (less than 25) without secondary outcomes at baseline. Overall, abnormalities in electrolytes have been linked to mortality and poor physical health outcomes, which emphasizes the need for monitoring and potential treatments to avoid negative consequences.

Source:

Solmi, M., Fabiano, N., Clarke, A. E., Fung, S. G., Tanuseputro, P., Knoll, G., Myran, D. T., Bugeja, A., Sood, M. M., & Hundemer, G. L. (2024). Adverse outcomes and mortality in individuals with eating disorder-related electrolyte abnormalities in Ontario, Canada: a population-based cohort study. In The Lancet Psychiatry (Vol. 11, Issue 10, pp. 818–827). Elsevier BV. https://doi.org/10.1016/s2215-0366(24)00244-x