All parameters of mineral metabolism are to some extent related: suppression of Klotho increases FGF23 levels, which in turn suppresses vitamin D. Increased phosphate, FGF23 and parathyroid hormone (PTH) are independent risk factor for CKD progression and cardiovascular mortality not only in primary CKD but also in kidney allograft recipients [21, 23–40]. Here, PTH is linked to chronic kidney disease.