@deedee99 The first nephrologist I saw was planning to put a fistula in my arm and start dialysis immediately. I asked about peritoneal and he said "that doesn't work I never recommend it". I found a nephrologist at another hospital who was willing to work with me to try to avoid dialysis. If you are in the NYC area you have lots of choices. You want to be very comfortable with your nephrologist. It's quite possible that you will be seeing him for a long time.