Therefore, it is assumed that the FGF23/D-serine axis has a regulatory role in hearing impairment in chronic renal failure and that lowering FGF23 levels may mediate a decrease in D-serine production, ultimately attenuating the effects of excitatory neurotoxicity in the central nervous system on the cochlea and preventing hearing impairment. The gene discussed is FGF23; the disease is hearing loss disorder.