Technical Aspects of Controlled Enteral Nutrition in Pediatric Dialysis

Concerns regarding the adequacy of nutritional intake among children with chronic renal failure are common, primarily due to the impact nutritional intake may have on growth and neurodevelopment. In some children, oral intake is insufficient to support normal growth and development, and must be supplemented with nasogastric (NG) or gastrostomy tube feedings, wherein nutrition is provided via a tube that delivers nutrients distal to the oral cavity. This chapter will review the rationale underlying the use of tube feeding, the existing evidence supporting the use of tube feeding in children with renal insufficiency, and the indications for tube feeding. In addition, we will consider the advantages and disadvantages of NG versus gastrostomy tube feeding, the practical details of tube feeding prescriptions, and the potential complications. The transition from tube to oral feedings will also be discussed.