Review: Vascular calcification in chronic kidney disease: the tip of the chalk-berg

The most common cause of death in dialysis patients is cardiovascular disease. As yet, no convincing evidence of useful therapeutic interventions exists. This huge increase in cardiovascular mortality may be due in part to the presence of excess vascular calcification, particularly in the form of extensive coronary artery calcification, which can be observed even in very young dialysis patients. The reasons for this very widespread problem are in fact complicated and numerous, with an interaction between patient characteristics, external changes, such as mineral and bone metabolism parameters, and other less well characterised influences. The use of sevelamer rather than significant doses of calcium as the primary oral phosphate binder seems to be associated with a reduction in the development and progression of vascular calcification, at least in some studies. Br J Diabetes Vasc Dis, 2008; 8: 264—269