Lioufas NM, Pedagogos E, Hawley CM, et al. - Given chronic kidney disease (CKD) carries excess cardiovascular morbidity and mortality vs the general population, researchers examined the influence of the phosphate binder lanthanum carbonate on intermediate cardiovascular markers in patients having stage 3b–4 CKD in an international, multi-centre, randomized, placebo-controlled trial, named the IMpact of Phosphate Reduction On Vascular End-points in CKD (IMPROVE-CKD) study. The alteration in carotid-femoral pulse wave velocity (PWV) following 96 weeks was the primary endpoint. There were 278 participants, with mean age 63 ± 13 years, 69% were male, 45% had diabetes, 32% had cardiovascular disease (CVD), 33% had stage 3b CKD and 67% had stage 4 CKD. Mean PWV was found to be 10.8 ± 3.6 m/s and 81% had abdominal aortic calcification (AAC). Factors related to PWV ≥ 10 m/s were: older age, diabetes, CVD, presence of AAC, higher systolic blood pressure (BP), larger waist circumference and higher alkaline phosphatase. The link of AAC with the following factors was identified: older age, male gender, diabetes, CVD, higher diastolic BP, dyslipidaemia (and use of statins), smoking, larger waist circumference and raised PWV. Overall, high baseline risk for cardiovascular events, suggested by high baseline PWV and AAC values, was evident among IMPROVE-CKD participants.