Previous studies showed a high prevalence of HFpEF in patients with MHD (7), and several renal factors including the activation of the RAAS, anemia, hyperphosphatemia, increased levels of FGF-23, and uremic toxins have impact on the HFpEF (46), which lead to HFpEF being more prevalent in patients with MHD. The gene discussed is FGF23; the disease is anemia (phenotype).