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Tube feeding in children with end-stage renal disease
B D Kuizon1, P A Nelson, I B Salusky
1Department of Pediatrics, UCLA School of Medicine 90095, USA.
Insights
Aggressive nutritional support, including tube feeding, is crucial for children with end-stage renal disease to improve growth and development. Early intervention with enteral nutrition maximizes potential, despite potential complications like vomiting or PD leaks.
Area of Science:
- Pediatric Nephrology
- Clinical Nutrition
Background:
- End-stage renal disease (ESRD) in children requires aggressive management.
- Nutritional support is vital for growth and neurodevelopment in pediatric ESRD patients.
Purpose of the Study:
- To emphasize the importance of early and aggressive nutritional therapy in children with ESRD.
- To review the role of supplemental enteral feeding in managing pediatric ESRD.
Main Methods:
- Review of current practices in pediatric nephrology centers in the US and Europe.
- Discussion of enteral feeding methods, including nasogastric (NG) and gastrostomy tubes (G-tube).
Main Results:
- Supplemental enteral feeding is widely recommended and improves growth and neurologic development.
- NG tubes may cause emesis; G-tubes may lead to PD leak or exit site infections.
Conclusions:
- Early initiation of aggressive nutritional therapy is essential for maximizing growth potential in children with ESRD.
- Tube feeding is indicated when voluntary intake is insufficient for caloric and protein needs or when growth is poor.
Abstract:
Aggressive nutritional support and treatment with peritoneal dialysis (PD) have been advocated in the management of children with end-stage renal disease. In recent years, supplemental enteral feeding has been recommended by the majority of pediatric centers in the US and Europe since it has been shown to improve growth and neurologic development. Tube feeding, most commonly using a nasogastric (NG) or gastrostomy tube (G-tube) must be instituted when voluntary intake does not consistently meet the caloric and protein requirements or when there is poor growth. Recurrent emesis is the most common complication with NG feeds, while PD leak and exit site infection have been described with G-tube feeds. The early initiation of aggressive nutritional therapy to maximize growth potential must be emphasized.