Studies have found that high phosphate can cause LVH, myocardial fibrosis, and increase the risk of cardiovascular death through the paracrine effect of FGF-23 (Courbebaisse and Lanske, 2018; Leifheit-Nestler and Haffner, 2018; Wang and Shapiro, 2019). This evidence concerns the gene FGF23 and Myocardial fibrosis.