Validating the 'Refeeding Index' in Adolescents with Anorexia Nervosa
Research type
Research Study
Full title
Validating the 'Refeeding Index' in Adolescents with Anorexia Nervosa
IRAS ID
143131
Contact name
Simon Chapman
Contact email
Sponsor organisation
South London and Maudsley NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Anorexia nervosa is a serious condition affecting children and young people which carries a lifetime mortality of 5-10%. It is a psychological condition where those affected have a fear of being overweight and this generates restrictive eating behaviours which lead to often significant and severe weight loss. At presentation children and young people are often profoundly and dangerously malnourished and require careful assessment of their physical state and cautious reintroduction of nutrition. Overzealous refeeding can lead to the well-described and serious consequence of the 'refeeding syndrome' (RFS), a condition where calorie reintroduction stimulates release of hormones (principally insulin) which cause dangerous fluid and electrolyte shifts (especially phosphate) precipitating cardiac arrhythmias, seizures or death.
RFS is fortunately rare, and whilst risk factors have been identified, their presence is not sufficiently reliable to predict cases. The main hallmark of RFS is the fall in phosphate after reintroduction of nutrition. In 2010 le Roux et al identified a biomarker which predicted the refeeding syndrome in 35 adult patients on intravenous nutrition. It was found to be both sensitive and specific in this population.
The purpose of this study is to assess the validity of this test in a very different group of patients: malnourished children and adolescents with anorexia nervosa. All patients diagnosed with Anorexia Nervosa from November 2014-2015 will be approached by the Child and Adolescent Eating Disorders Service to participate in the research study. Patients will have one additional blood sample taken each time they are taken for their scheduled blood tests, which are performed in line with our existing guidelines. Samples will be analysed retrospectively and results compared with clinical and biochemical outcomes.
REC name
London - West London & GTAC Research Ethics Committee
REC reference
15/LO/0089
Date of REC Opinion
2 Jun 2015
REC opinion
Further Information Favourable Opinion