Cardiovascular complications are obviously important in the management of dialysis patients, and ultrasonography can be used to evaluate cardiac indices that can predict these complications. However, long-term longitudinal changes in ultrasonographic cardiovascular indices in dialysis patients are not well known. Also, the implications of lipid metabolism for cardiovascular change in dialysis patients is controversial. We therefore analyzed ultrasonographic cardiac parameters and laboratory data for lipid metabolism in patients who had been on peritoneal dialysis (PD) or hemodialysis (HD) for 8 years and also in patients who had been on PD for 4 years followed by another 4 years on HD. We found that lipid metabolism was worse but that cardiovascular indices were more stable over time in PD patients than in HD patients. Mean blood pressure was also better maintained in PD patients. These results indicate that cardiovascular function can be maintained in PD patients over the long term, given that blood pressure is controlled even though dyslipidemia worsens.