Background：Recently, the age- and sex-specific incidence of end-stage kidney disease（ESKD）requiring dialysis in Japan has gradually decreased, except among men aged 80 and over. However, it remains unclear whether the characteristics of patients with chronic kidney disease who survive ESKD and start dialysis change over time. Here, we use data from the Japanese Society of Dialysis Therapy to determine changes in the prevalence of comorbidities, including dementia, cerebral infarction, cerebral hemorrhage, and limb amputation, among patients starting dialysis, obtained from two cross-sectional national surveys that were conducted in 2010 and 2018, in Japan. Methods： Patients who started dialysis in 2010 and 2018, aged 40 and over, were included. The prevalence of comorbidities at the end of 2010 and 2018 were compared by calculating the age- and sex-standardized prevalence ratio （SPR） and confidence interval （CI）. Results： The mean age of patients starting dialysis increased from 67.8 to 70.0 from 2010 （n = 37,238） to 2018 （n = 38,147; P ＜0.001）. In both surveys, conducted in 2010 and 2018, cerebral infarction was the most prev-alent comorbid condition （13.0% and 13.1%）, followed by dementia （12.7% and 11.3%）, cerebral hemorrhage （3.2% and 3.7%）, and limb amputation （1.7% and 1.7%）. Prevalence of dementia significantly decreased （SPR 0.80 [95% CI 0.77–0.83]） from 2010 to 2018, whereas prevalence of cerebral hemorrhage significantly increased （SPR 1.16 [95% CI 1.09–1.24]）. No significant changes were observed in the prevalence of cerebral infarction （SPR 0.97 [95% CI 0.94–1.01]） and limb amputation （SPR 1.06 [95% CI 0.96–1.16]）. Conclusions： Age- and sex-standardized prevalence of dementia significantly decreased among patients aged 40 years and over starting dialysis from 2010 to 2018, whereas the prevalence of cerebral hemorrhage significantly increased. Further studies are needed to confirm our findings.

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