This retrospective study evaluates the efficacy of peritoneal dialysis (PD) in mitigating acute kidney injury (AKI) associated with cardiac surgery in newborns. We analyzed data from 120 neonates up to 28 days old who developed AKI post-cardiac surgery and required PD. Statistical analysis was performed using SPSS 26. Results indicated that PD patients were predominantly male (p = 0,007) with an average age of 12,87 days versus 9,32 days (p = 0,015), and an average weight of 3,06 kg compared to 2,76 kg (p = 0,040). Multivariate regression highlighted age (OR = 1,083, p = 0,032), cardiopulmonary bypass duration (OR = 1,081, p = 0,030), and RACHS-1 scores (OR = 4,785, p = 0,037) as significant predictors of PD initiation. Among PD patients, non-survivors had an average age of 10,31 days versus 18,00 days for survivors (p = 0,045), and an average weight of 2,94 kg versus 3,54 kg (p = 0,040). Non-survivors also had shorter cardiopulmonary bypass times (33,63 minutes versus 50,60 minutes, p = 0,036) and aortic cross-clamp times (22,77 minutes versus 26,50 minutes, p = 0,015). Multivariate analysis also showed that younger age (OR = 0,927, p = 0,009), lower weight (OR = 0,597, p = 0,006), higher RACHS-1 scores (OR = 0,432, p = 0,002), longer bypass (OR = 0,969, p = 0,001), and longer cross-clamp times (OR = 0,871, p = 0,007) predicted decreased survival. PD benefits include reduced AKI severity and enhanced survival, particularly in complex cases, despite an increased sepsis risk