title: Efficacy of gastrostomy feeding in infants and older children receiving chronic peritoneal dialysis.
abstract: 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.
authors.affiliation: Division of Paediatric Nephrology, The Hospital for Sick Children and University of Toronto, Ontario, Canada.
authors.forename: I J
authors.initials: IJ
authors.lastname: Ramage
authors.forename: D F
authors.initials: DF
authors.lastname: Geary
authors.forename: E
authors.initials: E
authors.lastname: Harvey
authors.forename: D J
authors.initials: DJ
authors.lastname: Secker
authors.forename: J A
authors.initials: JA
authors.lastname: Balfe
authors.forename: J W
authors.initials: JW
authors.lastname: Balfe
mesh_terms: 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
chemical_list: D001798:Blood Proteins; D004044:Dietary Proteins