心臟血管疾病仍是導致末期腎臟病人死亡的主要原因，估計約有40%的透析病患，因心臟血管疾病死亡。造成慢性腎臟病心臟血管疾病，最主要的原因是動脈鈣化(Arterial calcification)。動脈血管的鈣化依據血管解剖生理學位置，可分為動脈血管粥狀硬化(Atherosclerosis)及動脈硬化(Artericsclerosis)。至於末期腎臟衰竭病人，發生血管鈣化因素很多，其危險因子如：高血磷、高血鈣、副甲狀腺亢進、活性維生素D3使用過量、發炎狀態等皆是，但仍以血磷過高為主要的致病機轉。本文除擬探討慢性腎臟病所造成血管鈣化的機轉外，並討論非金屬磷結合劑在治療慢性腎臟病血管鈣化所扮演的角色。

Cardiovascular disease is the leading cause of mortality in patients with chronic kidney disease (CKD) which attribute about 40% of dialysis patient's death. Vascular smooth muscle cell (VSMC) calcification contributes the most important factor of cardiovascular disease. Arterial calcification is divided into atherosclerosis of intima and arteriosclerosis of medial layer muscular tunica which is the prominent characteristic of vascular injury in CKD. There are many risk factors promote vascular calcification in CKD such as hyperphosphatemia, hypercalcemia, secondary hyperparathyroidism, active Vit D3 overdoses, and inflammation/oxidative stress. However, the elevated serum phosphate plays the most important cause of vascular calcification in CKD. This review article will discuss the pathos-physiological metabolic mechanisms of vascular calcification in CKD and the role of non-metal containing phosphate binder in the treatment of hyperphosphatemia. (J Intern Med Taiwan 2014; 25: 101-114)