A clinical case of a young patient with a long history of renal replacement therapy (RRT) is presented. Long-time RRT led to vascular complications and peritoneal dialysis (PD) was used as a rescue therapy. At the moment of presentation, the patient manifested symptoms of acute abdomen and an ischemic necrosis of ileus was diagnosed. The therapeutic decisions were strongly influenced by the lack of possible alternative methods of RRT. Despite the surgical procedure and intensive individualized care (pharmacotherapy, PD, nutrition, nursing) were introduced, the patient died. Nevertheless, it is our hope that the patient found possibly good quality of his last days through the means of palliative care that was introduced