Summary

Background and objectives In the last 15 years in Canada, there have been less stringent guidelines for peritoneal dialysis (PD) adequacy, availability of novel PD solutions, and lower PD-related peritonitis rates. Effects of these changes on outcomes of incident patients treated with PD during this period are unknown. Design, setting, participants, & measurements Risk of PD technique failure andmortality were compared among three incident cohorts of PD patients who initiated dialysis during the following periods: 1995–2000, 2001–2005, and 2006–2009. A multivariable model was used to evaluate time to PD technique failure using inverse probability of treatment and censoring weights accounting for changing survival and transplantation rates. Results Between 1995 and 2009,13,120 incident adult PD patients were identified from the Canadian Organ Replacement Register. Comparedwith the 1995–2000 cohort (n=5183), the risk of PD technique failure was lowe