Percutaneous endoscopic gastrostomy feeding in haemodialysis out-patients

Introduction Malnutrition is highly prevalent in haemodialysis (HD) patient s and plays a major role in influencing outcome. Although use of home enter al feeding is expanding rapidly in the UK, it is a method of nutritional su pport which remains under-utilized in HD out-patients. We report our experi ence and outcomes in a series of eight cases. Methods Home gastrostomy feeding was initiated in eight malnourished HD out -patients, administered either continuously overnight or as daily bolus fee ds. Nutritional parameters were monitored weekly by the renal dietitian and included dry weight, upper-arm anthropometry and serum albumin. The number and duration of hospitalizations during the period of feeding were recorde d. Results After 3 months of feeding, median dry weight increased from 43.0 to 48.3 kg (P = 0.012), mid-upper arm circumference increased from 20.2 to 24 .8 cm (P = 0.018), triceps skinfold thickness increased from 7.3 to 11.3 mm (P = 0.046), mid-upper arm muscle circumference increased from 17.7 to 19. 8 cm (P = 0.027) and serum albumin increased from 29.5 to 36.5 g L-1 (P = 0 .011). Few complications were encountered and hospital admission rates were low. Conclusion Home gastrostomy feeding, with appropriate monitoring and suppor t, is an effective method of improving and maintaining nutritional status i n this vulnerable group.