The term refeeding syndrome (RFS) refers to the metabolic perturbations and its attendant complications in subjects who are refed after fasting. The syndrome is characterized by profound shifts of electrolytes and fluids. Its consequences are widespread and sometimes fatal. Patients with malignancies are especially vulnerable due to the presence of multiple comorbidities. We report the course of four patients with malignant or hematological disorders who developed RFS while being treated for their underlying illness. All physicians caring for susceptible patients should be cognizant of the risks of refeeding and treat RFS appropriately to reduce patient morbidity as well as mortality.

The interesting report by Al-Hwiesh et al. (1) on the feasibility of peritoneal dialysis (PD) in patients with an indwelling permanent suprapubic catheter (PSPC) prompted us to contribute our experience of a patient with PSPC needing renal replacement therapy.A 62-year-old woman with a history of chronic kidney disease due to a mitochondrial disorder, i.e., maternally inherited diabetes and deafness (MIDD-syndrome), presented with acute on chronic kidney injury and was found to be in acute urinary retention, with a bladder volume of more than 1,000 mL. A neuropathic origin was presumed, given her underlying condition. A transurethral catheter was placed, but when a trial without catheter failed, a PSPC was inserted. No malfunction was reported in the further course, and regular changes were undertaken without complications.Over the next year, the patient's renal function declined relentlessly. When she reached end-stage kidney disease, she opted for PD. To ascertain the extraperitoneal position of the PSPC, magnetic resonance imaging (MRI) of the lower