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Nearly all dialysis patients require phosphate binders. These include traditional calcium-based compounds and, more recently, the calcium-free, metal-free, non-absorbed agent, sevelamer hydrochloride. Both binder types reduce serum phosphorus, but differ with respect to calcium load and metabolism. Absorption from calcium-based agents very likely promotes positive total calcium balance in many patients. Positive calcium balance is inappropriate in adults and may promote or accelerate soft-tissue and vascular calcification even in the absence of hypercalcemia. Calcium accumulation in heart and vascular tissues contributes to rapidly progressive cardiovascular calcification \u2013 a strong predictor of cardiovascular and all-cause mortality in stage 5 CKD. More than two-thirds of stage 5 CKD patients have calcification scores above the 75th percentile for matched controls \u2013 scores associated with extremely high risk of cardiovascular events and death.<\/jats:p>","DOI":"10.1159\/000083713","type":"journal-article","created":{"date-parts":[[2005,3,16]],"date-time":"2005-03-16T09:57:17Z","timestamp":1110967037000},"page":"12-19","source":"Crossref","is-referenced-by-count":15,"title":["Calcium Loading, Calcium Accumulation, and Associated Cardiovascular Risks in Dialysis Patients"],"prefix":"10.1159","volume":"23","author":[{"given":"Philip 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