When renal function declines in patients with chronic kidney disease the concentration of circulating FGF-23 is increased in response to persistent hyperphosphatemia [4]; however, increased levels of FGF-23 have also been associated with an increased risk of developing heart failure, cardiovascular disease, and cardiovascular death independent of renal function and other cardiovascular risk factors [5, 6]. This evidence concerns the gene FGF23 and chronic kidney disease.