Hypophosphatemia in the nutritional recovery syndrome
A. G. Mezoff, D. A. Gremse and M. K. Farrell
Division of Gastroenterology and Nutrition, Children's Hospital Medical Center, Cincinnati, OH 45229.
We studied the incidence of hypophosphatemia in patients during the
nutritional recovery syndrome. The charts of 150 patients receiving a
complete nutritional assessment for 18 months were reviewed; 45 met
established nutritional risk criteria. Only 9 of these 45 had serial
phosphorus values measured during nutritional repletion, and 5 of these 9
patients had hypophosphatemia (phosphorus levels less than 0.97 mmol/L).
Anthropometric measurements of arm circumference and arm muscle
circumference were less than the fifth percentile in all patients
developing hypophosphatemia. We concluded that hypophosphatemia is an
underrecognized complication of nutritional repletion and that
anthropometric measurements may be predictive of patients at risk. All
patients with significant malnutrition should be evaluated for this
complication of refeeding.
