Dietitians are accustomed to providing low-phosphorus nutrition education as a primary focus of kidney nutrition instruction for patients with chronic kidney disease. This is based on heavily researched evidence that excessive phosphorus intake leads to bone mineral disease and increased risk for cardiovascular disease in this population. Coronary-artery calcification is common and progressive in young adults with end-stage renal disease who are undergoing dialysis and occurs much earlier in adolescent patients than in the general population.