The impact of supplemental feeding in young children on dialysis: A reportof the North American Pediatric Renal Transplant Cooperative Study

Supplemental feedings are commonly recommended for young children on dialys is but their effect on growth parameters and mortality has not been well do cumented. We report the results of a North American Pediatric Renal Transpl ant Cooperative Study (NAPRTCS) survey on the impact of supplemental feedin gs on growth and mortality in children <6 years of age at dialysis initiati on. Sixty-four nonsurvivors (NonS) were matched with 110 survivors (S) for age at dialysis initiation, primary renal disease, and year of entry into t he NAPRTCS database. Questionnaires were completed by participating centers on 137 patients (51 NonS, 86 S). Supplemental feedings were given to 70% o f patients and more commonly given to patients <2 years of age compared to those 2-5 years of age at dialysis initiation (P <0.001). Supplemental feed ings were also more commonly given to patients with nonrenal disease in add ition to renal disease compared to those with renal disease only (P <0.001) . In patients receiving supplemental feedings, the method of supplemental f eeding was most commonly by nasogastric tube in patients <2 years of age co mpared to those 2-5 years of age (P=0.027). Supplemental feeding use was no t different in S compared to NonS. There were no differences in height stan dard deviation score (SDS), weight SDS, or change in height or weight SDS i n patients receiving supplemental feedings compared to those who did not. T he height and weight SDS did not improve over time on supplemental feeds. I n summary, despite the common use of supplemental feedings in young patient s on dialysis, height, weight, and mortality remain unaffected. Prospective long-term evaluation of this therapy is needed to determine the effectiven ess of supplemental feeding.