The most common cause of death in dialysis patients is cardiovascular disease (CVD). Although controversial, this may be due in part to the presence of excess vascular calcification (VC) particularly in the form of extensive coronary artery calcification (CAC), which can be observed even in very young dialysis patients, this may contribute to premature cardiovascular (CVD) disease and the markedly increased mortality observed in the dialysis population. ADMA increases oxidative stress and potentiates monocyte binding, which are two key processes in the genesis and evolution of atherosclerosis.