The increasing dialysis population is a global phenomenon. Taiwan still sat on the top of list regarding to dialysis prevalence, although incidence rate continuously fell in 2009 analysis. It is very interesting to ask the reason of dissociation between prevalence and incidence, and the survival trends of modern era. The purpose of this short review is to present trends of prevalence and survival after nationwide implementation of continuous quality improvement measurements since 2005. The 2009 data from TWRDS suggested 2 interesting finding and 1 prediction. First, the patient survival was reduced in the modern cohort in comparison to 1990-2001 cohorts. Second, the demographic characteristics of patients entering dialysis are changing. There are more diabetic and elderly patients in 2000- 2009 cohorts than older cohort. This ultimate phenomenon may contribute in part to the decrease survival of modern cohort. The current nationwide epidemiological data analysis suggested tentative prediction of future dialysis trend. Approximately 100 patients per million population increase in ESRD prevalence would be expected if the practice pattern and patient demography kept the same pace. Further effort should be given to slow down the increase of ESRD prevalence.