Other CKD alterations that further aggravate myocardial dysfunction are the over activation of systemic and intrarenal RAAS, the anemia that characterizes patients with CKD, vitamin D deficiency, and other mechanisms recently described, such as activation of mTOR, G-protein activation, and T-cell activation (7); all of them may influence cardiac structure and function. The gene discussed is MTOR; the disease is chronic kidney disease.