Tube feeding in children with chronic kidney disease: technical and practical issues

Rees, Lesley; Brandt, Mary L.

doi:10.1007/s00467-009-1309-4

Cited by 52 publications

(27 citation statements)

References 19 publications

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“…We do not know why so few children had a gastrostomy; one reason may be a relative reluctance to perform an open gastrostomy procedure, which is recommended instead of percutaneous placement when patients are already established on PD. 14,15 The lack of detailed data on the prescription and actual intake of nutrients is a limitation of our study. These types of data are difficult to collect and assess accurately.…”

Section: Discussionmentioning

confidence: 99%

“…14 An additional benefit of tube feeding beyond the provision of energy, protein, and fluid is the ability to use it to administer medications such as NaCl supplements, which are commonly required both in polyuric infants with structural renal abnormalities and in anuric infants with high ultrafiltration-related losses 4,12 ; salt depletion is known to limit growth. 10 Provision of NaCl by tube is much easier and causes less vomiting than administration by mouth.…”

Section: Discussionmentioning

confidence: 99%

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Growth in Very Young Children Undergoing Chronic Peritoneal Dialysis

Rees

Azócar

Borzych

et al. 2011

Journal of the American Society of Nephrology

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115

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Very young children with chronic kidney disease often have difficulty maintaining adequate nutrition, which contributes to the high prevalence of short stature in this population. Characteristics of the dialysis prescription and supplemental feeding via a nasogastric (NG) tube or gastrostomy may improve growth, but this is not well understood. Here, we analyzed data from 153 children in 18 countries who commenced chronic peritoneal dialysis at Ͻ24 months of age. From diagnosis to last observation, 57 patients were fed on demand, 54 by NG tube, and 10 by gastrostomy; 26 switched from NG to gastrostomy; and 6 returned from NG to demand feeding. North American and European centers accounted for nearly all feeding by gastrostomy. Standardized body mass index (BMI) uniformly decreased during periods of demand feeding and increased during NG and gastrostomy feeding. Changes in BMI demonstrated significant regional variation: 26% of North American children were obese and 50% of Turkish children were malnourished at last observation (P Ͻ 0.005). Body length decreased sharply during the first 6 to 12 months of life and then tended to stabilize. Time fed by gastrostomy significantly associated with higher lengths over time (P Ͻ 0.001), but adjustment for baseline length attenuated this effect. In addition, the use of biocompatible peritoneal dialysate and administration of growth hormone independently associated with improved length, even after adjusting for regional factors. In summary, growth and nutritional status vary regionally in very young children treated with chronic peritoneal dialysis. The use of gastrostomy feeding, biocompatible dialysis fluid, and growth hormone therapy associate with improved linear growth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Growth in Very Young Children Undergoing Chronic Peritoneal Dialysis

Rees

Azócar

Borzych

et al. 2011

Journal of the American Society of Nephrology

Self Cite

115

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“…Gastrostomy tubes or buttons are usually well tolerated, but are associated with an increased risk of exit-site infection and leakage, and especially in the case of a close PD catheter exit may increase the risk of bacterial or fungal peritonitis [163,218]. Whenever possible, the PD catheter should be placed either simultaneously or after placement of a gastrostomy to avoid contamination of the peritoneum from gastric contents [220]. In case a gastrostomy needs to be placed in a child with ongoing PD, open insertion and perioperative antibacterial and antifungal prophylaxis is advised.…”

Section: Nutritional Management Of Children Receiving Maintenance Permentioning

confidence: 98%

Peritoneal Dialysis in Children

Patel

Kv³

et al. 2015

Pediatric Nephrology

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In children with chronic kidney disease stage 5D peritoneal dialysis (PD) remains the dialysis modality most commonly prescribed, especially as automated PD. Nowadays it can be started from the first days of life on, and applied even to some preterm babies. This chapter gives an overview on PD membrane ultrastructure and function, on technical prerequistes of PD, on optimal PD prescription and on specific treatment targets and tools to monitor efficacy. It describes PD related infectious and noninfectious complications, long term peritoneal and systemic sequelae and current state of the art of how these can be mitigated or even be prevented.

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“…Likewise, it is recommended that, when possible, the PD catheter be placed either simultaneously or after placement of a Gtube to avoid contamination of the peritoneum from gastric contents. 28 When the catheter placement precedes G-tube placement, the latter procedure should take place under prophylactic antibiotic and antifungal therapy and with the patient drained of PD fluid.…”

Section: Pd Accessmentioning

confidence: 99%