Clinical and Echocardiographic Characteristics of Patients on Hemodialysis with Dialysis Vintage of More Than 30 Years: A Single-Center Comparison with Patients on Dialysis for 20 to 29 Years

Poster presented at ASN Kidney Week 2026 (Denver, CO, 22–25 October 2026),poster board TH-PO0888, in the session “Dialysis: Prescription, Physiology, and TreatmentOptimization” [PO0801-1]; ASN abstract 4559308. This record contains the poster and thetwo-page handout distributed at the board. Background. At the end of 2024 there were 324,092 patients receiving chronicdialysis in Japan, of whom only 27,709 (8.5 %) had a dialysis vintage of 20 years or more and8,076 (2.5 %) a vintage of 30 years or more. Sporadic reports describe the clinicalcharacteristics of such patients, but their cardiovascular phenotype has not been examined indetail by echocardiography. Methods. Single-center, retrospective, cross-sectional study of all 40 patientsreceiving maintenance hemodialysis at one hospital whose vintage at their most recentechocardiogram was 20 years or more. Each patient's own index echocardiogram, performed betweenSeptember 2022 and April 2026, was the index date from which age and vintage were counted and towhich laboratory values were matched (median interval 7 days, maximum 16). Patients were dividedinto a shorter-vintage group of 20–29 years (n = 24) and a longer-vintage group of30 years or more (n = 16). Medians [IQR] were compared by the Mann–Whitney U testand n (%) by the Fisher exact test; for continuous variables the Hodges–Lehmann mediandifference and its 95 % confidence interval were estimated. Twenty-seven variables werecompared, without correction for multiple comparisons. Results. Median dialysis vintage was 25 versus 35 years while age was similar(70 versus 71 years). None of the 27 variables tested reached P < 0.05— patient characteristics, echocardiographic findings and laboratory findings alike. Ejectionfraction was 66.0 versus 70.0 % (P = 0.118) and was preserved in both groups. The twovalues nearest the conventional threshold were serum albumin (P = 0.052) and body massindex (P = 0.058); with 27 comparisons and no correction for multiplicity these are nottreated as findings. Conclusion. Among patients who had already reached a dialysis vintage of 20years, a further decade of treatment was not associated with any difference in cardiovascularphenotype. This is considered to reflect the survival of only those patients who met thecardiovascular conditions compatible with continued survival. The study gives no basis for treatinglength of vintage in itself as an indicator of cardiovascular risk; being cross-sectional andconfined to survivors, it is equally no reassurance about any individual patient. Note on the analysis. The printed abstract (4559308) reports an earlier analysis in which the groups were defined at a fixed calendar date in 2024, giving n = 26 and n = 14. On that basis the laboratory values used lay a median of 142 days from the echocardiogram (maximum 577), and only 7 of the 40 patients had been sampled within a month of it. Age, dialysis vintage and group assignment are now indexed to each patient's own index echocardiogram, and every laboratory value has been re-matched to it (median interval 7 days, maximum 16; 40 of 40 within one month), giving n = 24 and n = 16. In this analysis the structural differences suggested in the abstract did not persist (LV end-diastolic diameter P = 0.354; LV mass index P = 0.230), and none of the 27 variables tested reached significance. The printed abstract is fixed as submitted, including any changes made up to 20 May 2026; this poster reports the current analysis. Ethics. Approved by the institutional ethics committee (approval number 26025)and conducted in accordance with the Declaration of Helsinki. Individual informed consent was notobtained; patients were informed in writing and given the opportunity to opt out.