Refeeding syndrome in at-risk hospitalized children: A descriptive study.

Cohort studyJPEN. Journal of parenteral and enteral nutrition· Aug 2026

Refeeding syndrome in at-risk hospitalized children: A descriptive study.

Faten Ahmad Alkateb, Fawziah Abdulhameed Abdulhalim, Awatif Khaled Almutairi … Ohoud Abdulhamid Fatah

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Pediatric Gastroenterology & NutritionCohort studyQ2IF 3.1

Refeeding syndrome occurred in about 1 in 10 at-risk hospitalized children

Refeeding syndrome in at-risk hospitalized children: A descriptive study.

Faten Ahmad Alkateb … Ohoud Abdulhamid Fatah

JPEN. Journal of parenteral and enteral nutrition · Aug 2026 · Q2 in General Medicine

Background

Refeeding syndrome is a metabolic condition characterized by severe electrolyte disturbances following nutritional rehabilitation in malnourished patients, with limited pediatric evidence.

Purpose

This study evaluated the implementation of locally adapted international guidelines in a Middle Eastern tertiary care setting.

Methods

We performed a descriptive cohort study of 133 children (28 days to 14 years) at the Children's Specialized Hospital, King Fahad Medical City (June 2024 to May 2025), stratified by refeeding syndrome risk.

n = 133 children

Results

refeeding syndrome developed in about 1 in 10 at-risk children despite screening

Incidence 9.80 (95% CI 5.60 to 16.10)

null 0

5.60

16.10

CI excludes the null - significant

More results

A nonsignificant increase was observed across risk categories (p = 0.43).

Lower body mass index z-scores correlated with refeeding syndrome (tau b = 0.163, p = 0.02).

Thiamine prophylaxis reached only 9 of 82 severe-risk patients (11.0%) despite 97.7% risk identification, revealing a critical implementation gap.

More results

Weight recovery was significant at 6 months.

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Conclusion · 1 of 2

Refeeding syndrome affects 1 in 10 pediatric patients. Risk stratification was associated with the absence of severe complications despite imperfect implementation.

Conclusion · 2 of 2

A critical gap in thiamine adherence (11.0%) demonstrates that guideline adaptation requires systematic implementation strategies beyond protocol development.

Refeeding syndrome in at-risk hospitalized children: A descriptive study.

Refeeding syndrome in at-risk hospitalized children: A descriptive study.

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