Peritoneal Dialysis in the Transplant Pathway: From Waitlist to Graft Failure.

Abstract

Peritoneal dialysis (PD) is recognized as a well-established and safe modality of replacement therapy for patients with end-stage kidney disease. Recently, its use has attracted growing interest as a bridge to kidney transplantation (KTx). Given several advantageous pathophysiological characteristics, such as continuous purification, preservation of residual kidney function, and reduced cardiovascular impact, PD may be associated with clinical characteristics that could facilitate pre-transplant management; . However, clinical evidence remains limited and fragmented, and shared practical frameworks for perioperative management are lacking, particularly regarding the retention or removal of the peritoneal catheter after KTx. This review aims to provide a comprehensive and updated overview of the scientific evidence regarding the use of PD in the transplantation process, analyzing the theoretical benefits, management issues, clinical outcomes, and future perspectives, including in the case of graft failure. Practical reflections grounded on clinical experience and suggestions for individualized patient management are also proposed.