ARPKD is a rare disorder but an important cause of early-onset pediatric kidney failure.1-3 PD has been recommended as the method of choice for initiating dialysis in infants and small children,4-6 but there are concerns regarding the feasibility of maintenance PD in ARPKD patients with their massively enlarged kidneys.2,7 Some centers perform uni- or bilateral nephrectomies of native ARPKD kidneys.8