In addition to higher phosphate levels per se, higher levels of FGF23 or lower levels (due to CKD) of the vasculoprotective αKlotho may contribute to a higher incidence of cardiovascular disease in CKD patients, by acting on VSMC and provoking vascular calcifications [98], and by inducing left ventricular hypertrophy [7, 30, 86]. This evidence concerns the gene FGF23 and chronic kidney disease.