# Prevention of end‐stage renal disease with percutaneous endoscopic gastrojejunostomy tubes in a patient with recurrent episodes of binge eating and purging

## TL;DR

A patient with long-term bulimia nervosa developed severe dehydration, and a PEG-J tube was used to prevent kidney failure.

## Contribution

This case highlights the use of PEG-J tubes to prevent ESRD in chronic bulimia nervosa.

## Key findings

- Chronic bulimia nervosa can lead to repeated dehydration and risk of ESRD.
- PEG-J tube placement effectively prevented further dehydration and renal progression.
- Long-term management of bulimia may require medical interventions to avoid organ damage.

## Abstract

Bulimia nervosa (BN) and the binge‐eating/purging subtype of anorexia nervosa (b/p AN) are characterized by binge eating and unsafe compensatory behaviors, such as laxatives or diuretic abuse, self‐induced vomiting, and excessive exercise. BN often causes miscellaneous physical complications that can lead to death. However, there have been very few prior reports on the physical complications of chronic BN.

We report a case of chronic BN of over 10 years. Her compensatory behaviors caused dehydration more easily than before. Repeated dehydration may result in end‐stage renal disease (ESRD). Therefore, we had to prevent dehydration by placing a percutaneous endoscopic gastrojejunostomy (PEG‐J) tube. After PEG‐J placement, dehydration did not reoccur, thereby protecting her renal involvement from progressing to ESRD.

Chronic BN exposure may cause repeated dehydration with time. Therefore, the PEG‐J tube would be effective in preventing dehydration, which leads to ESRD.