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Research Article | DOI: https://doi.org/CCSRR-RA-25-41

Incidence of Refeeding Syndrome in Malnourished Children Undergoing Treatment at Tehsil Headquarter Hospital Dogar, Central Kurram

Bilal Noor 1*, Muhammad Suliman 2, Hamid Iqbal 3

1 Pediatric consultant THQ Hospital central kurram Dogar

2 Clinical Technologist BSC (MLT) THQ Hospital central kurram Dogar

3 PMO Nasir Ullah Babar Memorial Hospital Peshawar.

*Corresponding Author: Bilal Noor, Pediatric consultant THQ Hospital central kurram Dogar

Citation: Bilal Noor, Muhammad Suliman, Hamid Iqbal (2025). Incidence Of Refeeding Syndrome in Malnourished Children Undergoing Treatment at Tehsil Headquarter Hospital Dogar, Central Kurram, J Clinical Case Studies and Review Reports. 2(5) 41, DOI: CCSRR-RA-25-41

Copyright: Bilal Noor, et al © (2025). This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 14 September 2025 | Accepted: 19 September 2025 | Published: 25 September 2025

Keywords: refeeding syndrome (rfs); severe acute malnutrition (sam) ; pediatric malnutrition; nutritional rehabilitation; electrolyte imbalance; mortality and morbidity; nutritional support protocols; retrospective cohort study; hospitalized children

Abstract

Background: Refeeding syndrome (RFS) is a potentially fatal condition occurring during the nutritional rehabilitation of severely malnourished children1,3,4. This study retrospectively analyzed medical records of malnourished pediatric patients admitted to Tehsil Headquarter Hospital Dogar in Central Kurram to determine the incidence of RFS, associated risk factors, and outcomes. Our findings underscore the importance of vigilant monitoring and gradual nutritional repletion in this vulnerable population to prevent the onset of RFS3,4. 

Objective: Incidence of refeeding syndrome in malnourished children undergoing treatment at Tehsil Headquarter Hospital Dogar, central kurram.

Study Design: Retrospective cohort study.

Place and Duration of study: Study conducted at Tehsil Headquarter Hospital Dogar central Kurram from Ist january to December 2023.

Materials And Methods: A retrospective cohort study was conducted to assess the incidence of refeeding syndrome (RFS) among severely malnourished children aged 6 months to 5 years admitted to Tehsil Headquarter Hospital Dogar, Central Kurram, from January to December 2023. Severe acute malnutrition (SAM) was defined per World Health Organization criteria5. RFS was identified based on clinical features and laboratory findings, including hypophosphatemia, hypokalemia, and hypomagnesemia occurring within 72 hours of initiating nutritional therapy6. Data on demographics, nutritional status, treatment protocols, and outcomes were collected and analyzed7. The study emphasizes the importance of vigilant monitoring and gradual nutritional repletion in this vulnerable population to prevent RFS. 

Result: Among 250 children with severe acute malnutrition (SAM), 35 (14%) developed refeeding syndrome (RFS)8,10. The mean age was 2.8 years, with a male-to-female ratio of 1.8:1. Key risk factors included prolonged inadequate nutrition and comorbid infections9. Electrolyte imbalances were managed with monitoring and supplementation, leading to a 90% recovery rate. However, three children succumbed to severe electrolyte disturbances.

Conclusion: Refeeding syndrome presents a considerable risk during the treatment of severely malnourished children. The 14% incidence rate observed in this study highlights the need for heightened awareness and proactive management strategies among healthcare professionals in similar settings. Implementing standardized protocols for the reintroduction of nutrition and electrolyte monitoring can significantly reduce morbidity and mortality associated with RFS.

References

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