Our exploratory cohort data support this hypothesis as with adequate post-ONDST dexamethasone levels and 8 Am plasma ACTH suppression, further decline of ONDST cortisol from 8 Am at 4 Pm was significantly less in the G5/5D CKD stage as compared to the G3/4 CKD stage and controls. The gene discussed is POMC; the disease is chronic kidney disease.