Why peritoneal dialysis should be the first treatment option

A change in the thought processes regarding peritoneal dialysis (PD) is long overdue. PD has been an overlooked and underutilized modality. Misconceptions and lack of pre-dialysis education about the benefits of PD deter patients and families from choosing PD. The benefits of preserving residual renal function, delaying the need for vascular access, being better prepared for transplantation, containing the cost of dialysis, and promoting self-care are some of the reasons why PD should be the first treatment option. There is a need for the rebirth of PD. Creating changes in the medical profession's perception, as well as in the patients' and their families' perception, of PD can happen only with education as to the positive aspects of the modality. Education is vital to changing the paradigm of thinking of hemodialysis as the first-line modality and of PD as a last resort. Reimbursement for pre-end-stage renal disease education classes may make education more accessible and help to reverse misinformation about PD. Helping patients and their families make an informed choice with regard to renal replacement therapy could also promote compliance.