Peritoneal dialysis versus haemodialysis (adult)

• Treatment starting with peritoneal dialysis (PD) may lead to more favourable survival in the first 1–2 years compared to starting treatment with haemodialysis (HD) (Level II evidence, small RCT). • Peritoneal dialysis compared with conventional HD is associated with equivalent or better survival in the first few years, especially with respect to residual renal function (RRF) (Level III evidence) • With loss of RRF, PD may lead to worse outcomes than HD (Level III evidence) • Haemodialysis is associated with improved long-term survival (Level III evidence) • A timely transfer from PD to HD may improve patient survival (Level IV evidence) • Renal programs should include an integrated PD/HD program where therapies are not competitive but rather complementary (Opinion) • Survival according to modality should be considered in the context of life quality as perceived by the patient when they are choosing HD or PD as initial therapy (Opinion)