The Factors That Cause Hypophosphatemia in Patients Receivig Clinical Nutrition Treatment

Abstract

Objective:One of the most important issues to be considered in patients who are started on nutritional therapy is refeeding syndrome (RS), which can occur within the first four days. Hypophosphatemia (serum phosphorus level <2.5 mg/dL) is an early symptom of refeeding syndrome. This study aimed to evaluate the rate of hypophosphatemia in different patient groups receiving nutritional therapy. This has been undertaken to examine the one-year follow-up results of an experienced clinical nutrition team (CNT) and the factors that cause hypophosphatemia.Materials and Methods:In this retrospective study, patients over 18 years of age and followed up by the CNT between January 2018-January 2019 were included. Patients’ characteristics, nutritional characteristics, serum phosphate levels and the relationship between these parameters and hypophosphatemia were evaluated.Results:Out of 622 patients who were included in the study, 11% showed hypophosphatemia. It was determined that 51.3% of the patients with hypophosphatemia were male (n=39), the median age was 66 years (range 21-95). The development of hypophosphatemia was ascertained to have a significant relationship with age (p=0.04), diet (p=0.01), surgery history (p=0.03), the status of reaching the target in parenteral nutrition (p=0.04) and the presence of additional disease (p=0.02). The multivariate regression analysis showed advanced age (p=0.03, Exβ=1.01) and surgery status (p=0.009, Exβ=2) increased the risk of hypophosphatemia.Conclusion:The advanced age and surgery, along with other already known factors, seem to increase the risk of hypophosphatemia, and therefore, more attention should be given to the clinical nutrition treatment in these patients.

Keywords

• hypophosphatemia
• clinical nutrition team
• refeeding syndrome