Nasogastric Tube Feeding in Infants on Peritoneal Dialysis

Abstract

Enteral nutritional support is an important component of the care provided to infants receiving long-term peritoneal dialysis. In the majority of published experiences on this subject, the use of the nasogastric tube has facilitated the provision of required calorie and protein intake and resulted in an improved patient outcome. Advantages of the nasogastric route of nutritional support include the ease of administration, while recurrent emesis remains the most troublesome and frequent shortterm complication associated with its use. Impaired oralmotor development may also result from nonoral feeding and should be addressed throughout the course of tube feeding.

The outcome of infants with ESRD receiving CPD has markedly improved since the introduction of NG feedings as a regular component of dialysis patient care. While complications associated with NG feedings have been documented, the benefits associated with this route of nutritional supplementation have been great. Currently, an increasing number of infants/ young children on CPD are receiving supplemental nutrition with the use of the gastrostomy tube/button (31). However, the risks associated with this route of therapy in the CPD population, especially in terms of infection, are as yet not well defined (32). Once the risk/benefit ratio of gastrostomy tube/button placement is determined, future efforts should be directed towards better defining how the two routes of enteral nutritional support (e.g., NG tube, gastrostomy tube/button) may best complement one another.