Acute kidney injury (AKI) is a common complication in pediatric patients following open heart surgery. Aim: This review investigates the contributing factors to AKI development and assesses the effectiveness of peritoneal dialysis (PD) as a kidney replacement therapy. Material and Methods: This literature review was conducted to examine factors contributing to the development of acute kidney injury (AKI) in pediatric patients after open heart surgery and to evaluate the effectiveness of peritoneal dialysis (PD) as a kidney replacement therapy method. Results: Key factors in AKI development include CPB usage, ischemia-reperfusion, and postoperative fluid excess. PD offers significant advantages such as ease of application, no need for anticoagulants, and large vein access. Timely PD implementation is crucial in reducing postoperative mortality rates. Complications of PD catheter placement include peritonitis, hydrothorax, and hemoperitoneum. Conclusion: Effective prevention and management of AKI in pediatric congenital heart defect patients are critical. Proper management of postoperative fluid excess and timely PD can improve clinical outcomes. Related studies on chronic kidney disease, fluid management post-surgery, and inflammatory response offer further insights into improving treatment and diagnosis in this patient population.