VDR and vitamin D deficiency: This dysbiosis may then result in cardiovascular disease, body wasting, and infections, and even causes deaths.[17,18] Vitamin D deficiency is a common problem in patients with CKD stages III to V.[19,20] Vitamin D is a potent immunomodulator, wherein monocytes and macrophages exposed to a bacterial lipopolysaccharide upregulate the vitamin D receptor gene, which results in the synthesis of cathelicidin, a peptide capable of destroying bacterial agents.[21–23] Therefore, it is rational that patients with vitamin D deficiency could be susceptible to increased death rates in the uremic cohorts.