[Peritoneal dialysis - the quiet alternative with a big impact].

PD, often underestimated, is more than a dialysis method - it is a promise of autonomy and quality of life. Especially in times of demographic shifts, rising chronic conditions, and healthcare staff shortages, PD is gaining relevance as an equal alternative to hemodialysis (HD). While HD dominates dialysis care in Germany (94%), international comparisons show a far more balanced use of modalities.PD utilizes the peritoneum as a natural dialysis membrane and can be performed manually (CAPD) or automatically at night (APD). With proper training, even elderly or dependent patients can safely manage PD at home or with support, enabling greater flexibility and reducing strain on healthcare infrastructure.General practitioners play a key role in early identification and education of chronic kidney disease (CKD) patients, offering PD as an empowering treatment path. Structured training and close monitoring help prevent complications such as peritonitis or peritoneal sclerosis.Remarkably, 55% of nephrologists would choose PD for themselves, compared to only 9% who would opt for the most commonly used method - center-based HD.PD is not a second-choice option. It is a viable, gentle, and forward-looking renal replacement therapy - an answer to the demographic and resource challenges ahead. Sometimes, modern nephrology begins not in a clinic, but quietly at the kitchen table.