Innovation and advances in peritoneal dialysis (PD) over time have resulted in significantly improved outcomes in end-stage renal disease (ESRD) patients. OBJECTIVES: To evaluate the current PD patient survival in the US and identify opportunities for improving PD patient care using recent available data. METHODS: Data was obtained from On-call Comparative Data Resource (Baxter Healthcare Corp., internal data), a program aimed at providing a comparative analysis of the reasons why patients enter or leave home dialysis. Over 30,000 incident patients who started peritoneal dialysis in 1999, 2000, and 2001 were included. Kaplan-Meier (KM) estimation was used to calculate the unadjusted actuarial patient survival. Adjusting for patients’ age, diabetic status, gender, center-size, and year of dialysis initiation, patient survival was also determined by Cox proportional hazard model. Censoring events in the analysis included switching to hemodialysis (HD), transplantation, death, and loss to follow-up, recovery of native renal function. RESULTS: One-year patient survival was 82%, 84%, and 86% respectively for 1999, 2000, and 2001 cohort, showing improvement over time. Two-year patient survival was also improved over time (69% in 1999, 72% in 2000, and 79% in 2001). The relative risk ratios of age, diabetes, and initial modality choice of CAPD (continuous ambulatory PD) vs. APD (automated PD) on patient survival were 1.038, 1.467 and 1.379 respectively. Dialysis center with less than 20 PD patients was not a significant risk factor for patient survival. The risk ratio of PD initiation year was 0.757, showing an improvement in patient survival over time. CONCLUSIONS: We found secular trend of improved outcomes as measured by patient survival of PD patients in the United States. The temporal profile of modality transfer from PD to HD could be used as a guide to practice optimization for PD patient care.