This article reviews the current understanding of high transport status in the peritoneal dialysis population and emphasizes survival can be improved for high transporters. To address the current state of knowledge on high peritoneal membrane transport, the negative impact of an increased peritoneal solute transport rate is first discussed. The potential downside of high transport status, notably on survival outcomes (as supported by registry data and meta-analysis), is highlighted. Based on recent advances and clinical studies, ways of maximizing the success of peritoneal dialysis treatment in high transporters are discussed, and management strategies are proposed.
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