title: Refeeding syndrome: problems with definition and management.
abstract: Refeeding syndrome (RFS) broadly encompasses a severe electrolyte disturbance (principally low serum concentrations of intracellular ions such as phosphate, magnesium, and potassium) and metabolic abnormalities in undernourished patients undergoing refeeding whether orally, enterally, or parenterally. RFS reflects the change from catabolic to anabolic metabolism. RFS sometimes is undiagnosed and unfortunately some clinicians remain oblivious to its presence. This is particularly concerning as RFS is a life-threatening condition, although it need not be so and early recognition reduces morbidity and mortality. Careful patient monitoring and multidiscipline nutrition team management may help to achieve this goal. The diagnosis of RFS is not facilitated by the fact that there is no universal agreement as to its definition. The presence of hypophosphatemia alone does not necessarily mean that RFS is present as there are many other causes for this, as discussed later in this article. RFS is increasingly being recognized in neonates and children. An optimal refeeding regimen for RFS is not universally agreed on due to the paucity of randomized controlled trials in the field.
authors.affiliation: Department of Clinical Biochemistry, Lewisham Hospital NHS Trust, London, United Kingdom; University of Greenwich, United Kingdom. Electronic address: martin.crook@doctors.org.uk.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Crook
mesh_terms: D002648:Child; D017408:Guidelines as Topic; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000209:etiology / Q000628:therapy; D017674:Hypophosphatemia / Q000097:blood / Q000209:etiology / Q000628:therapy; D007231:Infant, Newborn; D008274:Magnesium / Q000097:blood; D044342:Malnutrition / Q000628:therapy; D009748:Nutrition Disorders / Q000097:blood / Q000209:etiology / Q000628:therapy*; D010710:Phosphates / Q000097:blood; D011188:Potassium / Q000097:blood; D055677:Refeeding Syndrome / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000209:etiology / Q000628:therapy*
chemical_list: D010710:Phosphates; D008274:Magnesium; D011188:Potassium
keywords: Magnesium; Nutrition; Phosphate; Potassium; Refeeding syndrome