Hemodialysis and Peritoneal dialysis have been for many years the only method for renal replacement therapy in patients with renal failure. Efficiency and complications has been documented for each method. In this study, adequacy and complications reported during dialysis has been evaluated. The study comprised of 45 patients; 25 (55.55%) cases treated with hemodialysis with mean age at presentation of7.6±4.2years and 20 cases (44.44%) treated with peritoneal dialysis with mean age at presentation of 7.1±3 years. Adequacy of hemodialysis was assessed using kt/v formula for hemodialysis cases, dialysis was considered adequate if kt/v ≥ 0.7. In this study hemodialysis was adequate in (68%).Both bleeding tendency and metabolic acidosis were strong predictors of inadequate dialysis. The most common complications developed during hemodialysis were [hypotension (12%), vomiting (4%), respiratory distress (12%) and fever (12%)]. As regard peritoneal dialysis group; dialysis was adequate (45%) of cases with non significant correlation between clinical presentation and adequacy of dialysis. The most common complications reported were [leakage (15%), peritonitis (10%) and catheter block (15%)].