The implications of calcium-phosphate metabolism in vascular calcification and related cardiovascular risk are complex and remains poorly understood. A deranged calcium-phosphate metabolism is often described as a non-traditional cardiovascular risk factor in chronic kidney disease (CKD), and more recently in patients without advanced CKD.1 Notably, Mendelian randomization studies have described a causal relationship between serum phosphate and coronary artery calcification without hyperphosphat…