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Assessment of Risk of Refeeding Syndrome Caused by Early Nutrition in Low Body Weight Patients Referred to NST
J. Kor. Soc. Health-syst. Pharm. 2019;36:88-96
Published online February 28, 2019;
© 2019 Korean Society of Health-System Pharmacists

Kwang Joon Kima, Min Jung Shinb and Kyung Rye Moonc,

Department of Pharmacy, Chosun University Hospital, 365, Pilmundaero, Dong-gu, Gwangju, 61453, Republic of Koreaa, Department of Pharmacy, Ewha Womans University Mokdong Hospital, 1071, Anyangchunro, Yangchun-gu, Seoul, Republic of Koreab, Department of Pediatrics, School of Medicine Chosun University, 309, Pilmundaero, Dong-gu, Gwangju, 61453, Republic of Koreac
Correspondence to: 문경래 Tel:062-220-3052
Received June 8, 2018; Revised August 9, 2018; Accepted December 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background : Refeeding syndrome (RS) can result from after nutrition is provided to patients with a low nutritional status. RS is generally caused by electrolyte imbalances, such as hypokalemia, hypomagnesemia, and hypophosphatemia. RS can cause cardiovascular and nervous system side effects, leading to death of the patient.
Methods : In this study, 27 patients who were referred to our nutritional support team (NST) during the 6-month study period were divided into a low weight group with BMIs less than 16 kg/m2 and a normal weight group (100 to 105% of standard weights). We evaluated the nutritional doses given to the two groups at the time of initiation of parenteral or enteral nutrition and after three days, and compared the degree of RS expression based on hematologic clinical results.
Results : Blood tests for phosphorus were significantly decreased in the low weight group compared to the normal weight group (p=0.028). The caloric dose on the first day of the low weight group was statistically higher than the normal weight group (p=0.005).
Conclusions : The risk of RS was higher in patients with BMIs less than 16 kg/m2 who initially received high-calorie nutritional doses of 80% or more of the required dose, than in patients with normal body weights and calorie content below 50% of the required dose.
Keywords : Refeeding syndrome, Nutrition support, Low body weight