What is the primary risk associated with refeeding syndrome?

Refeeding syndrome is primarily characterized by significant shifts in electrolytes that occur when nutrition is reintroduced to individuals who have been in a state of malnutrition or starvation. This condition typically arises when feeding resumes after a period of inadequate intake, especially through intravenous or tube feeding.

During starvation, the body adapts to using fat stores for energy, leading to a depletion of key nutrients, particularly electrolytes such as phosphate, potassium, and magnesium. When feeding starts again, the body rapidly begins to utilize carbohydrates for energy, which stimulates insulin secretion. Insulin promotes the uptake of glucose along with electrolytes into the cells, resulting in potential deficiencies in the serum. Therefore, the most critical risk associated with refeeding syndrome centers on these dangerous electrolyte imbalances, which can lead to severe complications, such as arrhythmias, respiratory failure, and neurologic symptoms.

The other options, while relevant in some contexts, do not encapsulate the core danger of refeeding syndrome as accurately. High blood pressure, increased fluid retention, and high cholesterol can be concerns in different clinical situations but are not the primary risks linked specifically to the refeeding process.