Kaesler N, et al. - Whether nicotinamide (NA) alone and in combination with magnesium carbonate (MgCO₃) has efficacy as a potential novel treatment strategy to reduce phosphate levels and calcification and thus impact cardiovascular disease in chronic kidney disease (CKD) was investigated. Researchers performed subtotal nephrectomy and induced CKD in dilute brown non-agouti/2 mice; this was followed by administering a high-phosphate diet (HP) and 7 weeks of treatment with NA, MgCO₃ or their combination. Subtotal nephrectomy was also performed on control mice who were administered an HP or who underwent sham surgery and received standard chow plus NA. Increased serum fibroblast growth factor 23 and calcium–phosphate product, that was normalized by all treatment regimes, were detected among CKD mice. Findings revealed that ectopic calcification severity was increased by NA and decreased by MgCO₃. The addition of NA abolished augmented expression of intestinal phosphate transporters by MgCO₃ treatment. No benefit of NA was suggested with respect to treatment of calcification in addition to MgCO₃.