[Children on peritoneal dialysis and enteral feeding: indications and outcomes]

Despite improvements in overall prognosis, in the quality of life and in growth targets, children on peritoneal dialysis are subject to a high risk of growth retardation, especially if the disease begins in the early stages of life. In these patients, spontaneous feeding often does not provide an adequate intake of nutrients and early start of enteral nutrition needs to be considered. An intensive nutritional approach should always be established early and can be technically achieved using either a naso-gastric tube or a gastrostomy. In Italy, the first approach often involves the use of a naso-gastric tube despite epidemiological data suggesting the superiority of gastrostomy when the required outcome is improvement in growth parameters. Particular attention should be paid to the technique of gastrostomy. Despite this intensive approach, not all patients achieve the desired outcome of adequate growth probably because not all the possible mechanisms involved have yet been discovered.