Percutaneous endoscopic gastrostomy feeding in haemodialysis out-patients

Abstract

Introduction. Malnutrition is highly prevalent in haemodialysis (HD) patients and plays a major role in influencing outcome. Although use of home enteral feeding is expanding rapidly in the UK, it is a method of nutritional support which remains under-utilized in HD out-patients. We report our experience and outcomes in a series of eight cases. Methods. Home gastrostomy feeding was initiated in eight malnourished HD out-patients, administered either continuously overnight or as daily bolus feeds. Nutritional parameters were monitored weekly by the renal dietitian and included dry weight, upper-arm anthropometry and serum albumin. The number and duration of hospitalizations during the period of feeding were recorded. Results. After 3 months of feeding, median dry weight increased from 43.0 to 48.3 kg (P=0.012), mid-upper arm circumference increased from 20.2 to 24.8 cm (P=0.018), triceps skinfold thickness increased from 7.3 to 11.3 mm (P=0.046), mid-upper arm muscle circumference increased from 17.7 to 19.8 cm (P=0.027) and serum albumin increased from 29.5 to 36.5 g L-1 (P=0.011). Few complications were encountered and hospital admission rates were low. Conclusion. Home gastrostomy feeding, with appropriate monitoring and support, is an effective method of improving and maintaining nutritional status in this vulnerable group.