The timing of starting dialysis is a subject you should be discussing with your nephrologist. There is not a single number or test to use as a guide. It is best to start before you become very ill, and this is often when you have about 10% of your kidney function left. As for preservation of remaining kidney function, PD is best at protecting that, while HD commonly causes one to loose most or all remaining kidney function very quickly after starting dialysis. It is excellent that you have strong abdominal muscles. When you have the PD catheter inserted you will be restricted about exercises for several weeks, but once the surgeon says you are healed you will be able to resume those. While there are several different kinds of PD catheters and methods to insert them, they all involve the same tunnelling through the abdominal wall. But again, once healed, you should be fine. Hope this is helpful, and good luck.