[The refeeding syndrome in the elderly population : from hospital to home]

The refeeding syndrome (RS) is a consequence of passing from a catabolic state to an anabolic state triggered by renutrition that is followed by a prolonged period of fasting. Often under-diagnosed in the context of malnutrition or multimorbid patients, RS presents itself through nonspecific symptoms (oedema and tachycardia) that can rapidly progress in the first 72 hours into life threatening states. The internationally recognized NICE guidelines estimate the risk of RS and are based on BMI, weight loss and electrolyte levels. Several recent studies have addressed hypophosphatemia as a predominant marker allowing to better estimate refeeding syndrome gravity and risk. Patients who present a risk should have a progressive renutrition with an electrolyte substitution if required.