Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 7 (1), 11-6

Refeeding Syndrome: An Important Aspect of Supportive Oncology

  • PMID: 19278172

Refeeding Syndrome: An Important Aspect of Supportive Oncology

Mark A Marinella. J Support Oncol.


Refeeding syndrome (RFS) is an underappreciated, yet common and potentially dangerous, constellation of metabolic derangements that can occur upon reinstitution of any type of nutritional intervention. The typical patient who experiences RFS has been malnourished for days to weeks and develops hypophosphatemia and, occasionally, hypokalemia and hypomagnesemia when administered a carbohydrate load in the form of glucose-containing fluids, total parenteral nutrition (TPN), tube feedings, or an oral diet. The pathophysiology of RFS is complex but mainly results from an acute intracellular shift in electrolytes, increased phosphate demand during tissue anabolism, and formation of high-energy phosphate bonds. Potential complications of RFS include fatal cardiac arrhythmia, systolic heart failure, respiratory insufficiency, and hematologic derangements. Because supportive care of the cancer patient often involves nutritional and metabolic support, any clinician involved with providing acute or palliative oncologic care should be familiar with the risks, manifestations, and treatment of RFS.

Comment in

Similar articles

  • Refeeding Syndrome in Cancer Patients
    MA Marinella. Int J Clin Pract 62 (3), 460-5. PMID 18218007. - Review
    As RFS can have many adverse metabolic, cardiovascular, haematologic and neurologic complications, practicing oncologist needs to be aware of the pathophysiology, risk fa …
  • Refeeding Syndrome
    E Ladage. ORL Head Neck Nurs 21 (3), 18-20. PMID 12961792. - Review
    Refeeding syndrome can occur when nutrition is reinstituted in a starved patient and, if abnormalities are not corrected, can be lethal. This article describes metabolic …
  • [Malnutrition and Total Parenteral Nutrition: A Cohort Study to Determine the Incidence of Refeeding Syndrome]
    JC Hernández-Aranda et al. Rev Gastroenterol Mex 62 (4), 260-5. PMID 9580233.
    Refeeding Syndrome is a frequent entity in malnourished patients submitted to enteral or parenteral nutrition; at least in this study it was of 48%; its presence was foll …
  • The Refeeding Syndrome and Hypophosphatemia
    MA Marinella. Nutr Rev 61 (9), 320-3. PMID 14552069. - Review
    The refeeding syndrome is an underappreciated entity characterized by acute electrolyte derangements--notably hypophosphatemia--that occur during nutritional repletion of …
  • Recognizing and Preventing Refeeding Syndrome
    SM Adkins. Dimens Crit Care Nurs 28 (2), 53-8; quiz 59-60. PMID 19225312. - Review
    Refeeding syndrome is an uncommon but potentially fatal phenomenon that can occur in patients receiving parenteral, enteral, or oral feedings after a period of sustained …
See all similar articles

Cited by 4 PubMed Central articles

MeSH terms

LinkOut - more resources