End-stage renal disease (ESRD) in patients with eating disorders.

We report on the development of end-stage renal disease in four young women with long duration of eating disorders. No other reason for end-stage renal disease could be identified in these patients. Long standing hypokalemia was noted in all. Renal ultrasonography in three patients showed small kidneys with increased cortical echogenicity and multiple small bilateral cysts. A renal biopsy in one showed chronic tubulo-interstitial disease and non-specific glomerulosclerosis consistent with hypokalemic nephropathy. The development of end-stage renal disease is yet another medical complication to be considered in patients with long-standing eating disorder. Chronic hypokalemia may play a role in the pathogenesis of renal disease in this setting.