Aggressive nutritional support and treatment with peritoneal dialysis
(PD) have been advocated in the management of children with end-stage
renal disease. In recent years, supplemental enteral feeding has been
recommended by the majority of pediatric centers in the US and Europe
since it has been shown to improve growth and neurologic development.
Tube feeding, most commonly using a nasogastric (NG) or gastrostomy tu
be (G-tube) must be instituted when voluntary intake does not consiste
ntly meet the caloric and protein requirements or when there is poor g
rowth. Recurrent emesis is the most common complication with NG feeds,
while PD leak and exit site infection have been described with G-tube
feeds. The early initiation of aggressive nutritional therapy to maxi
mize growth potential must be emphasized.