title: Retroperitoneal feeding tube for peritoneal dialysis patients.
abstract: Treatment of the cachetic, hypoalbuminemic, peritoneal dialysis patient represents a vexing patient management problem. In the past, when the cause of inanition was intractable vomiting secondary to gastroparesis, the solution was to create a transperitoneal percutaneous enterogastrostomy. This endoscopic procedure bypassed the nonfunctioning stomach and allowed for adequate nutrition. When hypoalbuminemia is present, the patient is predisposed to the possible complications of peritoneal sepsis, dialysis fluid leak, and wound dehiscence. The authors report a unique, enteric feeding tube that is a solution to the problem of continuing adequate, complication-free dialysis in a cachetic, hypoalbuminemic peritoneal dialysis patient with no available site for either temporary or permanent hemodialysis vascular access. The procedure does not violate the peritoneal cavity and has proven to be effective, acceptable to the patient, apparently safe, and easy for both staff and patient use.
authors.affiliation: Department of Medicine, Kraftsow Division of Nephrology, Albert Einstein Medical Center, Philadelphia, PA 19141.
authors.forename: M S
authors.initials: MS
authors.lastname: Kramer
authors.forename: H A
authors.initials: HA
authors.lastname: Koolpe
authors.forename: S J
authors.initials: SJ
authors.lastname: Goldstein
authors.forename: M
authors.initials: M
authors.lastname: Mendez
authors.forename: R M
authors.initials: RM
authors.lastname: Raja
mesh_terms: D002100:Cachexia / Q000628:therapy*; D002408:Catheters, Indwelling; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007583:Jejunum; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000295:instrumentation*; D012187:Retroperitoneal Space