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 ). Design: Retrospective observational study. Setting: Pediatric nephrology division of tertiary care center. Patients: 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 (less than or equal to 2.5 years, n = 8); old er children (less than or equal to 2.5 years, n = 7). Main Outcome Measures: Assessment of the effect of CPD and g-tube feeding o n statural growth assessed by height standard deviation score (SDS) and per centage weight-for-height, and measured anthropometric variables including triceps skinfold thickness (TSF), midarm muscle circumference (MAMC), and m idarm 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 rep orted 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 incr ease was also observed in the older child group, being significant at 12 mo nths (p = 0.031 ) following g-tube insertion. Increases in all anthropometr ic variables occurred in the infant group during CPD and post g-tube insert ion, significant only for MAMC at 12 months (p = 0.037) post g-tube inserti on. In alder 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 w ere observed. Conclusions: Supplemental g-tube feeding facilitates weight gain in infants and older children receiving CPD and arrests the decline in height SDS tra ditionally observed in infants with end-stage renal disease. No significant alteration was observed in measured biochemical variables, although an inc rease in total protein and albumin was noted.