Similar outcomes were observed in a large meta-analysis of 15 prospective cohort studies, where elevated FGF-23 levels in non-dialysis patients with CKD stages 1–5 were associated with an increased risk of all-cause mortality (risk ratio [RR] 1.46; 95% CI 1.38–1.55; p < 0.001), cardiovascular disease (RR 1.37; 95% CI 1.15–1.63; p < 0.001), and renal events (RR 1.31; 95% CI 1.07–1.59; p = 0.008), including progression to ESKD or the initiation of dialysis [53]. Here, FGF23 is linked to chronic kidney disease.