Hence, the pathophysiology of SHPT, the relevance of tubular health in CKD and the renal protection elicited by VDR activation support 1,25(OH)2D as both marker of tubular synthesis and favorable predictor of WRF, nonetheless responsive to adaptive hormonal feed-backs in the context of CKD-MBD. Here, VDR is linked to Marchiafava-Bignami disease.