Blunted chronotropic and inotropic response to exercise [14], cardiac stunning [21], decreased oxygen delivery [45], pulmonary congestion [46], anemia [47], and skeletal muscle atrophy modulated by the upregulation of the IGF-1 signalling pathway [48] have been described as potential mechanisms affecting CKD patients beyond hypertension. The gene discussed is IGF1; the disease is Hypertension.