chapter  8
14 Pages

Nutritional Hypophosphatemia in Children

Hypophosphatemia is a significant complication of several conditions including the nutritional recovery syndrome in which hypophosphatemia is associated with enteral refeeding, total parenteral nutrition, anorexia nervosa, diabetic ketoacidosis, severe respiratory alkalosis, chronic antacid therapy, and the recovery phase after severe burns. The nutritional recovery syndrome is a significant cause of hypophosphatemia in children and is defined as a constellation of events occurring during the refeeding of significantly protein/ energy malnourished patients. Prolonged hypophosphatemia may result in the dysfunction of several different organ systems including hematologic, neurologic, nephrologic, and cardiovascular. Nutritional causes of hypophosphatemia in children have been most often described in the nutritional recovery syndrome. This syndrome, which is also known as the refeeding syndrome, is also associated with a wide variety of metabolic and physiological consequences caused by protein/calorie malnutrition. It is due to the metabolic and physiologic consequences of the depletion, repletion, compartmental shifts, and interrelationships of the following: phosphorus, potassium, magnesium, glucose metabolism, vitamin deficiencies, and fluid resuscitation. This discussion focuses on the disorders associated with phosphorus metabolism.1