While we agree with recommendations based on the excess dietary phosphate in western diets and known potential risks of excess phosphate [65], Chebib and Torres point out to an unclear rational, citing evidence that in ADPKD patients with preserved GFR hypophosphatemia is more frequent than in the general population and this was associated with high FGF23 levels and a renal phosphate leak. Here, FGF23 is linked to autosomal dominant polycystic kidney disease.