AIM. Investigate the relationship between markers of bone metabolism, especially osteoprotegerin, and the degree of coronary artery calcification as a key risk factor for heart disease in patients with chronic kidney disease. Chronic renal patients also develop a disorder of bone metabolism and vascular calcification, which affects an increased risk of cardiovascular disease and mortality. The aim is to investigate the relationship of cardiovascular risk assessment based on the analysis of traditional risk factors using the Framingham risk score with the assessment according to the analysis of coronary artery calcium score. MATERIAL AND METHODS. Blood samples were collected from patients with stage IV and V of chronic kidney disease and from persons 12 months after successful kidney transplantation. Serum biochemical analysis was performed. Anamnestic data were collected from patients according to the Framingham risk score. Coronary artery calcium score was determined. The expression of BMP-2, BMP-7, OPN, OPG, RANKL, RANK in the arterial wall with atherosclerosis or with calcification of media was analyzed by immunohistochemical method. RESULTS. Bone alkaline phosphatase (BAP) and acid phosphatase (TRAP5b) were significantly elevated in all groups compared to the control group. PTH was significantly higher in patients of all three groups compared to the control group. BAP and TRAP5b were significantly higher in patients with high PTH levels either in the hemodialysis group or among all subjects. OPG and sRANKL are significantly elevated in all three groups compared to the control group. CACs correlates significantly with age, with dialysis duration, serum phosphorus, and OPG levels. CONCLUSIONS. OPG in the blood increases with exacerbation of chronic kidney disease and there is also a statistically significant correlation between elevated serum OPG levels and CACs values. An increase in serum OPG levels is a significant biomarker of coronary arterial calcification progression. According to the FRS, we can determine the level of cardiovascular risk, but data indicate that patients at medium risk already have a very pronounced calcification of the coronary arteries.