The Ramipril Efficacy In Nephropathy (REIN) study conducted in patients with non-diabetic chronic nephropathies found that a 1 mg/dl increase in serum phosphate level was associated with a 85% excess risk of progression to ESRD [25, 26], possibly associated with high secretion of fibroblast growth factor 23 [25]. The gene discussed is FGF23; the disease is kidney disorder.