These biochemical parameters include serum calcium, phosphate, vitamin D and intact parathyroid hormone (iPTH).11,12 The biochemical parameters are used in conjunction with both the clinical information and bone dual X ray absorptiometry (DEXA).13 Recently, there has been a growing evidence supporting serum fibroblast growth factor 23 (FGF23) as a marker of CKD-MBD, in addition to being a correlate of cardiovascular disease (CVD).14 In normal homeostasis, FGF23 regulates and maintains a normal serum phosphorous. Here, PTH is linked to Marchiafava-Bignami disease.