Studies were performed to examine whether pulse wave velocity (PWV) is a useful indicator of arteriosclerosis in hemodialysis (HD) patients. In total, 72 patients were enrolled. Annual changes in PWV were compared to clinical parameters and therapeutic maneuvers. PWV increased in diabetic patients faster than non-diabetics (35 +/- 10 cm/s/month versus 10 +/- 4 cm/s/month, P < 0.05). Changes in PWV showed strong correlations to triglyceride level exposed during observation period (r = 0.50, P < 0.05) and HD duration (r = 0.46, P < 0.05). In addition, we found that PWV of some patients decreased (regressors), while the others increased (non-regressors). Regressors more frequently received combined treatment with angiotensin blockade and lipid-lowering drugs or vitamin E-coated dialyzers than non-regressors (P < 0.05). Our data demonstrate that PWV is useful as a marker of arteriosclerosis in HD patients. Furthermore, the present results suggest that combined treatment with both angiotensin inhibition and lipid-lowering drugs or vitamin E-coated membrane would slow the progression of arteriosclerosis in HD patients.