I am in Stage 4 CKD – most recent GFR was 20. I am interested in peritoneal dialysis when it gets to that stage. I understand the peritoneal surgical implant needs to heal for 3-4 weeks before use. Is there a medical necessity criterion for the surgery in anticipation of dialysis? I would like to get the surgery done so that I will be ready when/if the GFR drops to 15. My GFR has dropped from the high 30’s to 20 since January.

This is a discussion you should have with your nephrologist.  Catheters can be placed well before starting dialysis and can be left in place until needed.  In some cases, the catheter can even be buried below the skin and then a simple surgery can be used to expose the catheter so it is ready to use.  I suggest you discuss your concerns with your nephrologist.

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