Refeeding Syndrome : Mnemonics

Risk factors

Mnemonic: ABCD

  1. Alcohol abuse
  2. BMI <18.5 kg/sq.meter
  3. Chemotherapy
  4. Drugs (insulin) and Diuretics


Mnemonic: PPM

Malnourished (depleted intracellular Phosphate, Potassium, Magnesium) → Refeeding → Increased glucose load → Insulin spikes → Drives PPM into cells → Hypophosphatemia (major abnormality), hypokalemia, hypomagnesemia


If patient hasn’t not eaten for >5 days, aim to refeed at <50% energy and protein levels.

Monitor and aggresively supplement PPM.

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