Which electrolytes should be monitored for patients at risk of refeeding syndrome?

Refeeding syndrome is a serious condition that can occur when feeding is restarted in individuals who are malnourished or in a state of starvation. During this process, the body shifts back into an anabolic state, leading to increased demand for certain electrolytes, particularly phosphorus, potassium, and magnesium.

Among these, phosphorus is particularly critical because it plays a vital role in numerous cellular processes, including energy production (ATP synthesis) and bone health. A sudden influx of carbohydrates in refeeding can lead to significant shifts in phosphorus levels as it is utilized by the body to generate energy. Simultaneously, potassium levels can also drop due to insulin secretion, which encourages potassium to enter cells. This can lead to hypokalemia, posing risks such as cardiac arrhythmias.

Monitoring phosphorus and potassium in patients at risk of refeeding syndrome ensures that these critical electrolytes remain stable and that any imbalances are corrected promptly to avoid potentially life-threatening complications.