This session reviews the differences in peritoneal dialysis-related issues among pediatric PD patients including developmental changes of the peritoneum, the high prevalence of high transporters on PET, the impact on dialysis prescription, pH trauma caused by conventional PD solutions and long-term effects of PD using either conventional and physiologic PD solutions in children and adolescents. The session features unseen peritoneal biopsies after 6 years of PD using physiologic solutions.