A 76-year-old man with stage 4 CKD secondary to hepatorenal polycystic kidney disease with a history of long-standing arterial hypertension, type 2 diabetes mellitus, hyperuricaemia, dyslipidaemia and chronic obstructive pulmonary disease. Given the situation of advanced CKD and after explaining the different dialysis techniques, a straight, non-self-positioning 1 cuff peritoneal catheter was inserted by open surgery without immediate incidents and with good functioning during the training period. One month after placement of the catheter, continuous ambulatory peritoneal dialysis (CAPD) was started at home with a pattern of 3 exchanges of 2 litres of dextrose 1.5%, initially with neutral or negative balances of 200-300 ml. Four days after starting home treatment, he came to the peritoneal dialysis unit reporting genital oedema, with no other associated symptoms. After performing a testicular ultrasound scan, pathology at this level was ruled out. In view of the suspicion of leakage, a computerised axial tomography (CAT)-peritoneography was performed, after the administration (via catheter) of 100 ml of hypoosmolar iodised contrast (Optiray® 300 mg/ml), confirming the passage of peritoneal contrast material through the spermatic cord to the scrotum due to the presence of a permeable, although not dilated, peritoneovaginal process. There was also an ipsilateral left indirect inguinal hernia with a sac up to 58 mm in diameter. In view of these findings, it was decided to perform peritoneal rest and surgery was indicated to correct the inguinal hernia and close the peritoneovaginal duct. With these measures, and after restarting peritoneal dialysis with low volumes, one month after the reintervention, no new leak was observed.