Serum phosphate concentrations rise as chronic kidney disease (CKD) progresses and higher concentrations are associated with vascular calcification, cardiovascular events, and all-cause mortality.1,2 The relationship between serum phosphate and blood pressure (BP) is less established, but emerging data suggest that higher levels may induce microvascular dysfunction and increase BP.3,4 Here we looked at the association between phosphate-lowering medications and BP in advanced CKD.