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 wa s undertaken assessing the complications of g-tube feeding in children rece iving peritoneal dialysis (PD). Twenty-three patients, mean age 3.8+/-3.2 y ears received PD and g-tube feeding for 758 patient-months, with 127 patien ts receiving PD for 1,969 patient-months used as controls. Peritonitis occu rred 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 o ccurred every 126 patient-months before and 16.2 patient-months following g -tube insertion. PD catheter replacement secondary to infection occurred ev ery 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 sit e 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 c onclude that, although not without risk, g-tube feeding in patients receivi ng PD is not contraindicated.