Survival of paediatric dialysis patients in Türkiye over a three-year follow-up: findings from national database

Abstract 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 Türkiye. Methods We analyzed the national registry data to assess survival rates among pediatric patients on dialysis in Türkiye. 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 Türkiye, peritoneal dialysis has been shown to be associated with better survival rates than haemodialysis in children with stage 5 CKD, particularly among younger patients. Graphical Abstract