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Peritoneal dialysis technique survival in Australia and New Zealand is lower than in other parts of the world. More than two-thirds of technique failures are related to infective complications (predominantly peritonitis) and 'social reasons'. Practice patterns vary widely and more than one-third of peritoneal dialysis units do not meet the International Society of Peritoneal Dialysis minimum accepted peritonitis rate. In many cases, poor peritonitis outcomes reflect significant deviations from international guidelines. In this paper we propose a series of practical recommendations to improve outcomes in peritoneal dialysis patients through appropriate patient selection, prophylaxis and treatment of infectious complications, investigation of social causes of technique failure and a greater focus on patient education and clinical governance. This manuscript addresses the reasons why the peritoneal dialysis technique survival time is lower in Australia and New Zealand compared with many other parts of the world. The authors propose a series of practical recommendations to improve the outcomes in PD through appropriate patient selection, prevention and treatment of infectious complications, examining the causes of 'social' technique failure and addressing the need for a greater focus on patient education and clinical governance. [ABSTRACT FROM AUTHOR]