title: Hypokalemia during the early phase of refeeding in patients with cancer.
abstract: OBJECTIVE
  Refeeding syndrome occurs in patients with severe malnutrition when refeeding begins after a long period of starvation. This syndrome increases the risk of clinical complications and mortality. Hypophosphatemia is considered the primary characteristic of the syndrome. The aim of our study was to investigate the presence of other electrolyte alterations in patients with cancer during the early stage of refeeding.
  
  
  METHODS
  In this observational study, we enrolled 34 patients with cancer of the upper aerodigestive tract receiving upfront radiotherapy who were also enrolled in a nutrition program. A caloric intake assessment, anthropometric measurements and biochemical laboratory tests were performed.
  
  
  RESULTS
  Significant weight loss (∼20%) was found in these patients. In the patients receiving artificial nutrition, we found lower levels of potassium and total protein compared with those who were fed orally (p = 0.03 for potassium and 0.02 for protein, respectively). Patients on enteral tube feeding had a higher caloric intake compared with those who were fed orally (25±5 kcal/kg/day vs. 10±2 kcal/kg/day).
  
  
  CONCLUSIONS
  Hypokalemia, like hypophosphatemia, could be a complication associated with refeeding in patients with cancer. Hypokalemia was present in the early stages of high-calorie refeeding.
authors.affiliation: Clinical Nutrition Unit, Department of Medical and Surgical Sciences, University Magna Grecia of Catanzaro, Catanzaro, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Grasso
authors.forename: Yvelise
authors.initials: Y
authors.lastname: Ferro
authors.forename: Valeria
authors.initials: V
authors.lastname: Migliaccio
authors.forename: Elisa
authors.initials: E
authors.lastname: Mazza
authors.forename: Stefania
authors.initials: S
authors.lastname: Rotundo
authors.forename: Arturo
authors.initials: A
authors.lastname: Pujia
authors.forename: Tiziana
authors.initials: T
authors.lastname: Montalcini
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000886:Anthropometry; D002149:Energy Intake; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000532:radiotherapy; D006801:Humans; D007008:Hypokalemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy; D009752:Nutritional Status; D018529:Nutritional Support; D055677:Refeeding Syndrome / Q000150:complications*; D012307:Risk Factors; D015431:Weight Loss