In a prospective cohort of 351 patients with CKD stages two and three, Sánchez-Álamo et al. showed that the urinary DKK3 to creatinine ratio was significantly higher in patients that reached the primary composite outcome: a 50% increase in serum creatinine, end-stage kidney disease (ESKD), or death [19]. The gene discussed is DKK3; the disease is chronic kidney disease.