Chronic kidney disease (CKD) is a global health issue affecting 697.5 million people worldwide, with a significant burden on healthcare systems. CKD is associated with various complications, including cardiovascular, neurological, and metabolic disorders. A key complication is CKD–mineral and bone disorder (CKD-MBD), which involves dysregulation of bone turnover, mineralization, and vascular calcification. CKD-MBD is linked to alterations in mineral metabolism, including calcium, phosphate, parathyroid hormone (PTH), vitamin D, fibroblast growth factor-23 (FGF-23), and Klotho. These disturbances contribute to the progression of bone disorders and renal osteodystrophy (ROD). Vascular calcification (VC) is a critical component of CKD-MBD, accelerating CKD progression and contributing to cardiovascular events and mortality. Serum markers and imaging techniques, such as lateral plain X-ray, Kauppila Score, Adragao Score, and pulse wave velocity, aid in VC detection. pQCT provides valuable information on arterial calcifications. CKD poses a substantial global health burden, and its complications, including CKD-MBD and VC, significantly contribute to morbidity and mortality. Understanding the intricate relationships between mineral metabolism, bone disorders, and vascular calcification is crucial for effective diagnosis and therapeutic interventions. The review highlights the importance of managing CKD-MBD and VC through targeted therapies, including phosphate binders, calcimimetic drugs, and vitamin D. The complex pathophysiology of CKD-MBD and VC requires a multifaceted approach to mitigate these complications. The review also emphasizes the need for accurate diagnostic tools and ongoing research to improve the management of CKD and its complications.Chronic kidney disease (CKD) is a global health issue affecting 697.5 million people worldwide, with a significant burden on healthcare systems. CKD is associated with various complications, including cardiovascular, neurological, and metabolic disorders. A key complication is CKD–mineral and bone disorder (CKD-MBD), which involves dysregulation of bone turnover, mineralization, and vascular calcification. CKD-MBD is linked to alterations in mineral metabolism, including calcium, phosphate, parathyroid hormone (PTH), vitamin D, fibroblast growth factor-23 (FGF-23), and Klotho. These disturbances contribute to the progression of bone disorders and renal osteodystrophy (ROD). Vascular calcification (VC) is a critical component of CKD-MBD, accelerating CKD progression and contributing to cardiovascular events and mortality. Serum markers and imaging techniques, such as lateral plain X-ray, Kauppila Score, Adragao Score, and pulse wave velocity, aid in VC detection. pQCT provides valuable information on arterial calcifications. CKD poses a substantial global health burden, and its complications, including CKD-MBD and VC, significantly contribute to morbidity and mortality. Understanding the intricate relationships between mineral metabolism, bone disorders, and vascular calcification is crucial for effective diagnosis and therapeutic interventions. The review highlights the importance of managing CKD-MBD and VC through targeted therapies, including phosphate binders, calcimimetic drugs, and vitamin D. The complex pathophysiology of CKD-MBD and VC requires a multifaceted approach to mitigate these complications. The review also emphasizes the need for accurate diagnostic tools and ongoing research to improve the management of CKD and its complications.