Efficacy of gastrostomy feeding in infants and older children receiving chronic peritoneal dialysis.
OBJECTIVE
To assess the efficacy of supplemental gastrostomy tube (g-tube) feeding in infants and children receiving chronic peritoneal dialysis (CPD).


METHODS
Retrospective observational study.


METHODS
Pediatric nephrology division of tertiary care center.


METHODS
Fifteen patients undergoing g-tube insertion while receiving CPD were included in the study, and were subdivided, on the basis of age, into the following groups: infants (< or = 2.5 years, n = 8); older children (> 2.5 years, n = 7).


METHODS
Assessment of the effect of CPD and g-tube feeding on statural growth assessed by height standard deviation score (SDS) and percentage weight-for-height, and measured anthropometric variables including triceps skinfold thickness (TSF), midarm muscle circumference (MAMC), and midarm mean circumference (MAC). Assessment of the effects of CPD and g-tube feeding on measured biochemical variables including total protein, albumin, cholesterol, triglycerides, and high density lipoprotein.


RESULTS
No significant change in height SDS was observed; however, the reported continuing decline in height SDS in infants was arrested. Percentage weight-for-height increased significantly in infants at 6 months (p = 0.008) and 12 months (p = 0.006) following initiation of g-tube feeding. An increase was also observed in the older child group, being significant at 12 months (p = 0.031) following g-tube insertion. Increases in all anthropometric variables occurred in the infant group during CPD and post g-tube insertion, significant only for MAMC at 12 months (p = 0.037) post g-tube insertion. In older children little change occurred during CPD, with all variables increasing post g-tube insertion, significant only for MAMC at 6 months (p = 0.02) and 12 months (p = 0.02). An increase in total protein and albumin was noted; however, no significant changes in any biochemical parameters were observed.


CONCLUSIONS
Supplemental g-tube feeding facilitates weight gain in infants and older children receiving CPD and arrests the decline in height SDS traditionally observed in infants with end-stage renal disease. No significant alteration was observed in measured biochemical variables, although an increase in total protein and albumin was noted.
Ramage
I J
IJ
Division of Paediatric Nephrology, The Hospital for Sick Children and University of Toronto, Ontario, Canada.
Geary
D F
DF
Harvey
E
E
Secker
D J
DJ
Balfe
J A
JA
Balfe
J W
JW
D000886:Anthropometry; D001798:Blood Proteins / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D004750:Enteral Nutrition; D005774:Gastrostomy; D006128:Growth; D006801:Humans; D007223:Infant; D010530:Peritoneal Dialysis; D012189:Retrospective Studies; D015430:Weight Gain
D001798:Blood Proteins; D004044:Dietary Proteins