1. 1 Antonio Bellasi, MD Medical manager Genzyme, Italy Chronic Kidney Disease-Mineral Bone Disorders (CKD-MBD)

2. 2 Kalantar-Zadeh K, Kuwae N, Regidor DL, et al. Kidney Int. 2006;70:771-780. Survival Predictability: Baseline Phosphorus and All-Cause Mortality N=58058

3. 3 Kalantar-Zadeh K, Kuwae N, Regidor DL, et al. Kidney Int. 2006;70:771-780. Survival Predictability: Baseline Phosphorus and All-Cause Mortality N=58058

4. 4 Survival Predictability: Baseline Calcium and All-Cause Mortality Kalantar-Zadeh K, Kuwae N, Regidor DL, et al. Kidney Int. 2006;70:771-780. N=58058

5. 5 Survival Predictability: Baseline PTH and All-Cause Mortality Kalantar-Zadeh K, Kuwae N, Regidor DL, et al. Kidney Int. 2006;70:771-780.

6. 6 Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease  Medline, Embase and Cohcrane databases were systematically searched for articles published between January 1980 and December 2007  Results:  A significant risk of mortality (all-cause-CV) and CV events was observed with mineral metabolism disturbances  Data support a greater mortality risk with phosphorous, followed by calcium and parathyroid hormone (PTH)  Conclusion  Serious limitations were observed in the quality and methodology across studies. In spite of enormous heterogeneity across studies, a significant mortality risk was observed with mineral disturbances in dialysis patients. Data on risk in prdialysis patients were less conclusive due to even more limited (numerically) evidence Covic et al Nephrol Dial Transplant 2008; ePub November 11, 2008

7. 7 Serum Phosphorous and mortality in CKD patients:  Kestenbaum et al (J Am Soc Nephrol 2005; 16:520-528) :  All-Cause mortality risk per increase of 1 mg/dl: 33% (p<0.001)  MI risk per increase of 1 mg/dl: 35% (p<0.05)  Menon et al (Am J Kidney Dis 2004; 44:661-671) :  All-Cause mortality risk per increase of 1 mg/dl: 10% (p=0.46)  CV mortality per increase of 1 mg/dl: 27% (p=0.12)  Voormolen et al (Am J Kidney Dis 2004; 44:661-671) :  Risk per increase of 1 mg/dl: 68% (p=0.042)

8. 8 Investigation of Gender Heterogeneity in the Associations of Serum Phosphorus With Incident Coronary Artery Disease and All-Cause Mortality Onufrak et al, Am J Epidem; ePub Nov 2, 2008. Age-adjusted all-cause of mortality according to quintile of of serum phosphorus level among men (top; for comparison of outcomes in various phosphorus quintiles, P < 0.0001) and women (bottom; P = 0.16), Atherosclerosis Risk in Communities Study, 1987–2001