Peritoneal dialysis adequacy is most commonly assessed by indices of small solute clearance (Kt/Vurea and creatinine clearance [Ccr], for example). Once a threshold of small solute clearance has been obtained, however, further increases in small solute clearance do not result in improved long-term outcomes of peritoneal dialysis (PD) patients. In addition to small solute clearance, there are several other factors that may affect optimal dialysis outcomes. These include, but are not limited to: volume homeostasis, infiammation, malnutrition, and mineral/bone metabolism. This article will briefiy review data regarding the relationships between these various factors and survival on PD.