PEDIATRIC NEPHROLOGY, 2026 (SCI-Expanded, Scopus)
Background Dialysis is a life-saving treatment for children with stage 5 chronic kidney disease (CKD), but it is associated with a high long-term mortality that varies between countries. The aim of this study was to compare 3-year survival rates of children and adolescents on peritoneal dialysis (PD) and hemodialysis (HD) based on national data from T & uuml;rkiye. Methods We analyzed the national registry data to assess survival rates among pediatric patients on dialysis in T & uuml;rkiye. Kaplan-Meier and Cox proportional hazards models compared PD and HD survival outcomes, adjusting for age, period of initial dialysis commencement, and primary diagnosis. Results The study included 1,002 children with a mean age of 12.71 +/- 4.80 years. The overall mortality rate among pediatric dialysis patients was 25.8 deaths per 1000 patient-years, with adjusted analyses showing a 5-year survival advantage for PD over HD (adjusted p = 0.000001). The median adjusted survival probability was 0.89 (IQR 0.26) for PD and 0.83 (IQR 0.08) for HD, and PD demonstrated superior outcomes particularly in non-CAKUT children aged 6-12 and > 12 years (p = 0.004 and 0.013, respectively). Multivariate Cox regression analysis revealed that haemodialysis, initiation of dialysis between 2006 and 2018, and younger age (< 12 years) were independently associated with an increased risk of mortality in paediatric dialysis patients. Conclusion In T & uuml;rkiye, peritoneal dialysis has been shown to be associated with better survival rates than haemodialysis in children with stage 5 CKD, particularly among younger patients.