In the hemodialysis population, cardiovascular calcifications result from excess phosphate and calcium, as well as reduced activity of inhibitors of calcification, such as matrix Gla protein.
According to a long-term safety study and a separate FDA internal study, Prolia had an increased risk of hypocalcemia in patients with advanced kidney disease on dialysis.
The VITAL randomized clinical trial tested vitamin D and marine omega-3 fatty acid supplements in the primary prevention of cancer and cardiovascular disease.