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Hospitalization burden in children on dialysis: insights from the Italian Registry of Pediatric Chronic Dialysis

Rachele Spagnol1,2, Edoardo La Porta3, Daniela Zugna4

  • 1Pediatric Nephrology Unit, Department of Women and Children Health, University-Hospital of Padua, Padua, Italy. rachele.spagnol@unipd.it.

Pediatric Nephrology (Berlin, Germany)
|January 19, 2026
PubMed

Insights

Children on chronic dialysis face frequent hospitalizations. Hemodialysis (HD) showed a lower hospitalization risk compared to peritoneal dialysis (PD) in pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Chronic Kidney Disease Management

Background:

  • Children on kidney replacement therapy (KRT) experience frequent hospitalizations.
  • Recurrent hospitalizations pose significant challenges for pediatric patients undergoing dialysis.
  • Understanding hospitalization patterns is crucial for improving care in pediatric dialysis populations.

Purpose of the Study:

  • To compare hospitalization rates and causes between children on chronic peritoneal dialysis (PD) and hemodialysis (HD).
  • To analyze the long-term outcomes of PD versus HD in pediatric patients regarding hospitalization.
  • To identify key factors influencing hospitalization in children undergoing dialysis.

Main Methods:

  • Nationwide retrospective observational study using data from the Italian Registry of Pediatric Chronic Dialysis (IRPCD).
  • Inclusion of pediatric patients (<18 years) on chronic PD or HD from January 2000 to December 2019.
  • Categorization of hospitalization causes including infectious and non-infectious dialysis-related complications, other infections, non-infectious conditions, and kidney failure complications.

Main Results:

  • Out of 847 pediatric dialysis patients, 420 (51.7%) were hospitalized.
  • Dialysis-related infections were the most common cause (24.3%), especially in PD patients.
  • Hemodialysis (HD) demonstrated a significantly lower risk of hospitalization compared to peritoneal dialysis (PD) (aHR 0.75) and a lower likelihood of treatment changes.

Conclusions:

  • Pediatric patients on chronic dialysis, particularly those on PD, face a substantial hospitalization burden.
  • Hemodialysis (HD) appears to offer a protective effect against hospitalization over time in pediatric populations.
  • Targeted strategies are needed to reduce hospitalization risks in children receiving chronic dialysis, especially for PD patients.
Abstract

Keywords:
Chronic hemodialysisComplicationHospitalizationPediatricsPeritoneal dialysis

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