Background: Intraperitoneal pressure (IPP) is a critical parameter for optimizing dialysis prescriptions in pediatric PD. However, existing measurement techniques often lack clinical feasibility , and clinical evidence regarding the factors associated with IPP in children remains limited in China. Aim: This study aimed to develop and validate a non-invasive, closed-system device for IPP monitoring and to identify the relevant factors associated with IPP. Methods: We initially developed a novel device and validated its feasibility and safety . Subsequently enrolled pediatric patients who underwent peritoneal dialysis at a tertiary specialized pediatric hospital in Shanghai . IPP was measured using Durand’s method across a range of serial fill volumes (400 to 1400 ml/m²). Multivariable linear regression Models were utilized to identify factors associated with IPP. Results: In the pilot validation (n=9) ,this device achieved 91.0% measurement success rate without incidence of catheterassociated adverse events. Vital signs including oxygen saturation, pulse rate, and respiratory rate remained within normal ranges for all patients, and pain scores were consistently zero.The subsequent retrospective study included 115 pediatric patients with a median (IQR) age of 6.0 (4.0–11.0) years. All pediatric patients demonstrated satisfactory compliance with the measurement process. Regression analysis identified fill volume indexed to BSA as a strong positive predictor of IPP (B=0.974, P