Considering that P-binders attenuate P overload and decrease FGF23 levels37, their use is recommended in patients with hyperphosphatemia, given that they can prevent P overload-induced systemic inflammation, block the vicious cycle of inflammation and malnutrition, inhibit impairments in immune function, and thereby reduce the risk of infection-related mortality in patients undergoing hemodialysis. This evidence concerns the gene FGF23 and hyperphosphatemia.