As the dialysis population grows, the number of survivors in the second and even third decade of dialysis also increase. These long term survivors face not only the universal complications of dialysis such as anemia and hyparathyroidism but also the consequences of these complications such as the long term cardiovascular problems. They are also subjected to many years of accumulation of "uremic metabolites" resulting in conditions unique to this group of patients, the best example being dialysis amyloid. This book not only describes the causes of morbidity and mortality during the second decade of dialysis but also how these complications can be prevented or minimised. "As you make your bed so you must lie upon it". Survival and quality of life in the second decade and beyond dialysis cannot be divorced from events in the first decade. The longest survival is currently in those patients who have dialysed long hours with tight control of fluid status. Modern dialysis practice and its impact on survival - CAPD, short hour hemodialysis, biocompatible membranes are all discussed in this book.