The limits of peritoneal dialysis

Abstract

Peritoneal dialysis (PD) failed to meet the expectations not only of nephrologists but also of those companies that invested so much in this field. After 40 years of studies, the main evidences show the little biocompatibility of PD and the unexpected strong reaction of the peritoneum, which tries in every way to defend itself against what it considers an external aggression. Although much has been done to make PD more easily acceptable, this procedure implies a number of frequent complications that urge the nephrologist to use PD only when there are absolute indications for intracorporeal treatment or contraindications to extracorporeal dialysis, thus excluding, for the moment, PD as a treatment of first choice.