Tubefeeding syndrome is defined by which combination of findings?

• A. Azotemia, hypernatremia and dehydration due to high protein tube feeding with inadequate fluids
• B. Hypokalemia and hyponatremia due to low fluid intake
• C. Hyperglycemia with dehydration due to excessive carbohydrate
• D. Hypovolemia with electrolyte-normal renal function

Answer: (A)

Tubefeeding syndrome arises when a high-protein tube feeding is given with insufficient free water, leading to a specific pattern of azotemia, hypernatremia, and dehydration. The elevated protein load increases nitrogenous waste production, raising the blood urea nitrogen. If fluid intake is inadequate, the patient becomes dehydrated and the elevated solute load concentrates sodium, resulting in hypernatremia. This combination—azotemia from the nitrogen load, hypernatremia from water deficit, and dehydration from insufficient fluids—defines the syndrome.

In practice, you’d monitor for rising BUN with dehydration and a relatively high serum sodium, and you’d prevent or treat it by ensuring adequate free water with tube feeds or adjusting the formula to provide sufficient fluids. The other scenarios describe different electrolyte or metabolic disturbances that don’t fit the same pattern of excessive protein with inadequate hydration.