Compared to the “older” CKD-MBD biomarkers and already established in clinical routine, phosphate and PTH, which however display increased levels when CKD is already advanced, newer biomarkers, FGF23, Klotho, and sclerostin, give a bit more hope as there is growing evidence suggesting that their disturbed serum levels can detect initial CKD (Table 1). This evidence concerns the gene PTH and Marchiafava-Bignami disease.