In dialysis patients, there is an association between vascular calcifications and mortality. Hyperphosphatemia and calcium overload are associated with development of vascular calcifications, especially in the presence of low bone turnover. Different plain X-ray methods are now available to evaluate vascular calcifications in dialysis patients. The presence of vascular calcifications is an alert sign for increased cardiovascular risk, and this information is important for choosing the most suitable treatment for dialysis patients.