Growth posttransplantation in children previously treated with chronic dialysis and gastrostomy feeding

Nasogastric and gastrostomy feeding are beneficial in providing nutritional support to children on chronic dialysis, but concerns have been raised about transfer to exclusive oral nutrition postrenal transplantation (TX). The present study reports the growth data and feeding outcomes in 14 children (9 male) who received combined dialysis [continuous cycling peritoneal dialysis (CCPD): n = 12; hemodialysis (HD): n = 2] and gastrostomy button (GB) feeding for a mean duration of 15.6 months, and who were transplanted at a mean age of 5.4 years. In 12 patients GB feeding was discontinued shortly after TX, and in 2 it was maintained for 3 and 8 months, respectively. No infective episodes were attributable to the GB post-TX, and the buttons were usually removed within 3 months with the dialysis catheter. The mean height and weight standard deviation scores (SDS) were -2.44 and -2.29, respectively, prior to dialysis and GB feeding; -2.19 and -1.22, respectively, prior to TX; and had improved to -1.6 and -0.79, respectively, 12 months post-TX. The mean percentage weight-for-height at the time of TX was 105% (range: 86%-128%), and was unchanged 1 year post-TX. We conclude that GB feeding in this group of children resulted in few complications or feeding problems post-TX. The use of GB feeding without growth hormone maintained growth parameters in most children while on dialysis, and a significant improvement in growth occurred after the renal transplantation.