Polycythemia is not associated with RFS, but anemia due to hemolysis can occur. Respiratory failure may complicate severe hypophosphatemia due to diaphragmatic muscle weakness from inadequate ATP production. Hypophosphatemia also may be detrimental to erythrocyte morphology leading to cell rigidity and hemolysis. Ventricular tachycardia is the most feared complication of RFS and results from hypokalemia, hypomagnesemia, and hypophosphatemia.
