Refeeding Syndrome: Review Article

Refeeding syndrome is a potentially life-threatening condition that occurs when nutritional support is reintroduced after prolonged starvation or malnutrition. It primarily affects high-risk groups, such as individuals with eating disorders and patients with renal failure undergoing hemodialysis. This syndrome is marked by profound metabolic and electrolyte disturbances, including hypophosphatemia, hypokalemia, hypomagnesemia, and thiamine deficiency, which can lead to severe cardiovascular, hematologic, and neurological complications. A literature review was conducted using key words: "Refeeding syndrome," "Malnutrition," "Electrolyte imbalance," and "Critical care nutrition." This process identified 94 PUBMED articles, of which 31 were selected based on their relevance to the pathophysiology, prevention, diagnosis, and treatment strategies of the condition. Diagnosing refeeding syndrome is particularly challenging, as it necessitates ruling out other acute conditions, such as fluid overload, which can significantly lower plasma electrolyte levels. Moreover, the syndrome's aftermath requires thorough assessment, especially in cases involving independent cardiac arrhythmias like long QT syndrome, which pose heightened risks due to electrolyte imbalances. Prevention strategies focus on the early identification of at-risk patients, a controlled and gradual increase in caloric intake, and stringent electrolyte monitoring. Although various management approaches have been proposed, significant debate continues due to the lack of standardized data and quantification methods. This article offers an updated review, compiled by a team of experts, integrating the latest scientific findings from medical literature to deepen understanding and improve clinical management of refeeding syndrome.