Background <p>Demographic changes and specialized personnel shortages are a substantial burden on dialysis care in Germany. With rising patient numbers and limited resources, ensuring adequate care becomes increasingly more challenging. Peritoneal dialysis (PD) could provide a&#xa0;viable alternative to hemodialysis (HD) but remains underutilized in Germany.</p> Aim <p>To describe how PD can contribute to securing dialysis care and to identify barriers limiting its utilization in Germany.</p> Material and methods <p>Analysis of current studies and statistical data on dialysis care in Germany, including a&#xa0;comparison of survival rates, quality of life and cost efficiency of PD versus HD.</p> Results <p>The use of PD demonstrates comparable survival rates to HD while offering advantages in quality of life and resource efficiency. It enables home-based care and reduces the demand for specialized personnel in dialysis centers; however, the spread of PD is hindered by low awareness, partly inadequate reimbursement structures and infrastructural limitations.</p> Discussion <p>A stronger promotion of PD could improve the safety of dialysis care in Germany in the long term. Necessary measures include awareness campaigns, adjustments to reimbursement systems and expansion of training capacities. These changes would not only alleviate pressure on dialysis services but also enhance patient autonomy.</p>