HYPERKALEMIA, ELEVATED ALANINE AMINOTRANSFERASE LEVELS, LOW BODY MASS INDEX AND HYPOTENSION ARE ASSOCIATED WITH A HIGHER INCIDENCE OF REFEEDING HYPOPHOSPHATEMIA IN PATIENTS WITH ANOREXIA NERVOSA

Refeeding hypophosphatenzia is a hallmark of refeeding syndrome. We explored factors that could predict emergence of refeeding hypophosphatenzia in hospitalized patients. We retrospectively reviewed the charts of 19 consecutive patients with malnutrition due to Anorexia Nervosa who were hospitalized in Japan from August 2004 to August 2013. We collected data on age, body mass index, vital signs, and laboratozy data on admission. These data were compared between patients who had developed refeeding hypophosphatenzia (< 0.81 nzmol/L) during hospitalization (RH group, n=10) and those who had not (non-RH group, n=9). The mean age of patients was 30.5 +/- 10.8 years and mean body mass index was 11.2 +/- 2.1 kg/m(2). Ten (53%) patients developed refeeding hypophosphatemia and one (5.3%) developed refeeding syndrome. The RH group had significantly lower blood pressure and body mass index, and higher levels of alanine aminotransferase, sodium, and potassium than the non-RH group (t-test, p < 0.05). There was a significant tendency to develop RH with higher potassium and alanine aminotransferase levels, and lower body mass index and systolic blood pressure (Cochran-Armitage trend test, p < 0.05). Hyperkalemia, elevated alanine aminotransferase, low body mass index and hypotension could be predictive factors for refeeding hypophosphatemia caused by Anorexia Nervosa.