What is the expected clinical finding in a patient with refeeding syndrome?

Refeeding syndrome is a potentially serious condition that can occur when nutrition is restarted in individuals who are malnourished or have been in a state of starvation. It results from metabolic shifts that occur when carbohydrates are reintroduced into the diet, leading to a rapid release of insulin and subsequent shifts of electrolytes into the cells.

Hypomagnesemia is a key finding in refeeding syndrome as magnesium is often depleted in prolonged malnutrition, and the refeeding process can further exacerbate the deficiency. This is significant because magnesium plays a critical role in numerous biochemical processes in the body, including those related to neuromuscular function and energy metabolism.

As the patient begins to receive calories, particularly carbohydrates, the body reacts by driving glucose and associated electrolytes like phosphate and magnesium into the cells, leading to low serum levels of these electrolytes. This can contribute to various clinical symptoms and complications, such as cardiac arrhythmias and neuromuscular dysfunction.

In contrast, while other electrolyte imbalances like hypokalemia can occur during refeeding syndrome due to insulin's action, hypomagnesemia is particularly characteristic and a more direct effect of the refeeding process. Hyperglycemia and hypernatremia are less commonly associated with refeeding