Refeeding syndrome

Q: What is refeeding syndrome?

Refeeding syndrome describes what can occur when a patient with anorexia or extreme malnutrition begins to ingest more food. During refeeding, there is a shift from fat to carbohydrate metabolism. Increased amounts of insulin are released, facilitating cellular glucose uptake and protein anabolism. This results in an increased cellular uptake of phosphate, magnesium, and potassium, leading to decreased serum phosphorous levels.

Consequences can include rhabdomyolysis, decreased cardiac muscle function, cardiomyopathy, respiratory and cardiac failure, hemolysis, acute tubular necrosis, seizures, and delirium.

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New England Journal of Medicine - Vol. 359, No. 12, September 18, 2008