title: Body size in children with chronic kidney disease after gastrostomy tube feeding.
abstract: Outcome body size of gastrostomy tube (g-tube)-fed children with chronic kidney disease (CKD) was investigated. CKD patients, stages 2-5, who had a g-tube inserted and removed between 1985 and 2007 were retrospectively reviewed (n=20) for anthropometrics, lab values, and steroid use from insertion to latest date. CKD patients never having had a g-tube placed (n=82) acted as the comparison population with similar data collection at start and end of the latest 5-year period. Body mass index (BMI)-for-age, weight (Wt)-for-age, and height (Ht)-for-age z scores were calculated and compared between groups. Median age at insertion and duration of g-tube treatment was 1.7 years (range 0.9-15.6), and 2.9 years (range 0.9-11.8), respectively. There was a significant increase in Wt- (p<0.01), and BMI-for-age (p<0.03) z score, but not for Ht-for-age between insertion and removal for subjects. There were no significant differences in Ht-, Wt-, or BMI-for-age z scores, from removal to 5 years post-removal. In the comparison population, there were no significant differences in Ht-, Wt-, or BMI-for-age z scores over the 5-year period. Approximately 36% of the non-tube-fed comparison population and 50% of the tube-fed subjects were overweight or obese at the most recent evaluation. In both subjects and the comparison group, overweight and obesity is associated with transplant status and steroid use. G-tube feeding is an effective method for achieving catch-up weight and moderate height gain in pediatric CKD patients, and does not apparently predispose patients to obesity after removal; however, overweight and obesity may pose problems to children with CKD whether or not they are tube fed.
authors.affiliation: Division of Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Julianna L
authors.initials: JL
authors.lastname: Sienna
authors.forename: Rola
authors.initials: R
authors.lastname: Saqan
authors.forename: Jun Chuan
authors.initials: JC
authors.lastname: Teh
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Frieling
authors.forename: Donna
authors.initials: D
authors.lastname: Secker
authors.forename: Vivian
authors.initials: V
authors.lastname: Cornelius
authors.forename: Denis F
authors.initials: DF
authors.lastname: Geary
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D049628:Body Size; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male