The objectives of this study were to determine the impact that medical and socioeconomic status have on incident peritoneal dialysis (PD) use. In a prospective cohort study, 77 consecutive end-stage renal disease patients (53% women, mean age, 57.5 ± 16.5 years) who were planned to start dialysis were assessed for PD eligibility. The physicians' referral rate for PD consultation was 71%. One-half of the patients had important medical and socioeconomic barriers to PD, such as lack of family support, learning and performance disability, and less-than-ideal home situation. Patients with barriers were older, low educated, and more likely to be diabetic. In conclusion, consultation with a multidisciplinary team and the availability of health care systems financial supports are important drivers of PD. In addition, there is a likely need for further educational activities focused on PD, in order to change physicians' preference towards hemodialysis.