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Vascular calcification, which is highly prevalent in patients with chronic kidney disease, is relevant to mortality in hemodialysis patients. For more than three decades, loss of renal mass has been regarded as inducing a decrease in active vitamin D3, which leads to hyperparathyroidism with impaired calcium (Ca) and phosphate (P) homeostasis. Hyperparathyroidism causes osteolysis, which releases excess Ca and P and promotes their precipitation.