Refeeding syndrome

Refeeding syndrome (RFS) is a serious metabolic disorder caused by improper procedure of realimentation in patients, who are starved or severely malnourished. All clinical features of the syndrome are result of many metabolic changes, which are mainly caused by depletion of phosphate, potassium, magnesium and thiamine, as well as retention of sodium and disturbed glucose metabolism. The theoretical part of this thesis summarizes the current knowledge about the prevention of the RFS. The research part of the thesis explores the influence of intense realimentation in high-risk patients, particularly the values of various biochemical parameters before or during the early beginning of the realimentation. We measured values of indirect calorimetry, BMI, serum concentrations of phosphate, potassium, magnesium, prealbumin, albumin, zinc, iron and vitamin D. We also monitored concentrations of phosphorus, potassium, magnesium and cortisol in urine. We reported reduced values of potassium in urine for all patients (5/5) and reduced values of phosphate in urine for four patients (4/5). In four patients (4/5) we also monitored decreased levels of serum prealbumin, including two patients even below the value of 0.1 g/l, which is considered to be a significant risk factor for the development of the RFS. We..