Refeeding syndrome in the frail elderly population: prevention, diagnosis and management

Clinical and Experimental Gastroenterology
Emilie AubryZ Stanga

Abstract

Aging is linked to physiological and pathophysiological changes. In this context, elderly patients often are frail, which strongly correlates with negative health outcomes and disability. Elderly patients are often malnourished, which again is an independent risk factor for both frailty and adverse clinical outcomes. Malnutrition and resulting frailty can be prevented by adequate nutritional interventions. Yet, use of nutritional therapy can also have negative consequences, including a potentially life-threatening metabolic alteration called refeeding syndrome (RFS) in high-risk patients. RFS is characterized by severe electrolyte shifts (mainly hypophosphatemia, hypomagnesemia and hypokalemia), vitamin deficiency (mainly thiamine), fluid overload and salt retention leading to organ dysfunction and cardiac arrhythmias. Although the awareness of malnutrition among elderly people is well established, the risk of RFS is often neglected, especially in the frail elderly population. This partly relates to the unspecific clinical presentation and laboratory changes in the geriatric population. The aim of this review is to summarize recently published recommendations for the management of RFS based on current evidence from clinical stu...Continue Reading

Citations

Aug 26, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Marcel Kjaersgaard EriksenChristian Lodberg Hvas
Nov 24, 2019·Current Gastroenterology Reports·C L McKnightB Daley
Nov 23, 2019·Journal of Clinical Medicine·Emilie ReberStefan Mühlebach
May 28, 2019·European Journal of Clinical Nutrition·G JanssenUNKNOWN working group on nutrition and metabolism of the German Geriatric Society (DGG)
Jul 7, 2019·Journal of Clinical Medicine·Dorothee VolkertRainer Wirth
Oct 20, 2020·Internal and Emergency Medicine·Valentina PonzoSimona Bo
Feb 5, 2021·The Journal of International Medical Research·Alberto Lo GulloClemente Giuffrida
Sep 14, 2020·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Nina Kaegi-BraunPhilipp Schuetz
Jun 16, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Karina de Vargas Cony, Carlos Fernando de Magalhães Francesconi
Aug 28, 2021·Nutrients·Aileen HillArved Weimann

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