Complications of gastrostomy feeding in children receiving peritoneal dialysis.
Gastrostomy tube (g-tube) feeding is recognized to improve the nutritional delivery to children with end-stage renal disease. A retrospective study was undertaken assessing the complications of g-tube feeding in children receiving peritoneal dialysis (PD). Twenty-three patients, mean age 3.8+/-3.2 years received PD and g-tube feeding for 758 patient-months, with 127 patients receiving PD for 1,969 patient-months used as controls. Peritonitis occurred every 18.4 patient-months in controls and 7.8 patient-months in those with a g-tube. Peritonitis occurred every 6.0 patient-months before and 8.1 patient-months after g-tube insertion in those undergoing g-tube insertion on PD. PD catheter exit site infection (PDESI) occurred every 18.7 patient-months in controls and 16.8 patient-months in those with a g-tube. PDESI occurred every 126 patient-months before and 16.2 patient-months following g-tube insertion. PD catheter replacement secondary to infection occurred every 109.4 patient-months in controls and 39.9 patient-months in those with a g-tube. It did not occur before g-tube insertion and occurred every 32.5 patient-months following insertion. Thirty-four episodes of g-tube exit site infection occurred, in 10 the same organism caused concurrent peritonitis. G-tube replacement occurred on 37 occasions. Hemodynamically significant gastrointestinal bleeding occurred in 3 patients, being terminal in 1. We conclude that, although not without risk, g-tube feeding in patients receiving PD is not contraindicated.
Ramage
I J
IJ
Hospital for Sick Children, Department of Pediatrics, University of Toronto, Ontario, Canada.
Harvey
E
E
Geary
D F
DF
Hébert
D
D
Balfe
J A
JA
Balfe
J W
JW
D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D002404:Catheterization / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies