Tube feeding in children with end-stage renal disease.

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.