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Peritoneal dialysis is a renal replacement therapy that uses the lining of the abdominal cavity—the peritoneum—as an internal filter to remove waste products and excess fluid from the blood. Dialysate, a sterile fluid with a specific composition of electrolytes and glucose, is introduced into the peritoneal cavity through a surgically placed catheter. Over a dwell time that typically ranges from two to twelve hours, solutes and excess water diffuse across the peritoneal membrane into the dialysate, which is then drained and replaced with fresh fluid. The process can be performed autonomously by the patient at home (continuous ambulatory peritoneal dialysis, CAPD) or by a machine (automated peritoneal dialysis, APD) that cycles exchanges overnight while the patient sleeps.

Indications for peritoneal dialysis include end‑stage renal disease, acute kidney injury when continuous venovenous hemofiltration is unavailable, and as a bridge to transplantation or haemodialysis. It is particularly useful in patients with limited vascular access, those who prefer a portable treatment, or in settings where haemodialysis infrastructure is lacking.

Advantages of peritoneal dialysis include better preservation of residual renal function, a lower risk of infections that affect the bloodstream, and higher patient autonomy. Disadvantages encompass the need for a functional peritoneal membrane, potential for peritonitis, hernia formation, and a lower clearance of middle‑molecular‑weight toxins compared to haemodialysis.

Complications may involve peritoneal membrane failure, catheter obstruction, ascites, and electrolyte imbalances. Peritoneal dialysis has evolved since its first clinical application in the 1960s, with advances in biocompatible solutions and catheter design improving outcomes. The choice of dialysis modality is individualized based on patient preferences, medical conditions, and healthcare resources.