Which statement about refeeding syndrome is true?

Which statement about refeeding syndrome is true?

• A. It affects only pediatric patients
• B. It does not involve electrolyte changes
• C. It can cause rapid declines in phosphorus, potassium, and magnesium
• D. It is prevented by aggressive caloric loading

Answer: (C)

Refeeding syndrome arises when a malnourished patient begins receiving nutrition, especially with carbohydrates, and a surge of insulin drives shifts of electrolytes into cells. This creates rapid drops in key minerals as the body tries to restart metabolism after a period of starvation. The statement that is true is that it can cause rapid declines in phosphorus, potassium, and magnesium. Insulin promotes intracellular uptake of phosphate for ATP production and carbohydrate metabolism, leading to hypophosphatemia. Potassium and magnesium also move into cells more readily during this refeeding process, producing hypokalemia and hypomagnesemia. These electrolyte disturbances can trigger serious complications such as cardiac arrhythmias, respiratory failure, muscle weakness, and neurologic symptoms. Thiamine deficiency is another concern because carbohydrate metabolism increases demand for this vitamin during refeeding. Management focuses on being cautious with caloric initiation—start with a small amount of calories and increase gradually—while closely monitoring and correcting electrolyte abnormalities (phosphate, potassium, magnesium) and providing thiamine supplementation before and during refeeding. Aggressive caloric loading worsens the risk rather than prevents it, and refeeding syndrome can occur in adults and children alike.

Refeeding syndrome arises when a malnourished patient begins receiving nutrition, especially with carbohydrates, and a surge of insulin drives shifts of electrolytes into cells. This creates rapid drops in key minerals as the body tries to restart metabolism after a period of starvation.

The statement that is true is that it can cause rapid declines in phosphorus, potassium, and magnesium. Insulin promotes intracellular uptake of phosphate for ATP production and carbohydrate metabolism, leading to hypophosphatemia. Potassium and magnesium also move into cells more readily during this refeeding process, producing hypokalemia and hypomagnesemia. These electrolyte disturbances can trigger serious complications such as cardiac arrhythmias, respiratory failure, muscle weakness, and neurologic symptoms. Thiamine deficiency is another concern because carbohydrate metabolism increases demand for this vitamin during refeeding.

Management focuses on being cautious with caloric initiation—start with a small amount of calories and increase gradually—while closely monitoring and correcting electrolyte abnormalities (phosphate, potassium, magnesium) and providing thiamine supplementation before and during refeeding. Aggressive caloric loading worsens the risk rather than prevents it, and refeeding syndrome can occur in adults and children alike.