Frequently, PD is stopped due to resistant or recurrent peritonitis, inadequate clearance, concurrent illness, or lack of home support. Recent reports estimate that 10% to 30% of incident patients switch from PD to HD within the first year, and this patient cohort tends to have higher mortality versus those on PD therapy only.1-4 This may be associated with high catheter use, although this is unproven.1,5 Patients switching between modalities require regular follow-up for a smooth transition.4 Patterns of vascular access creation may be important benchmarks for this process of care.