FGF23 and calcification: A single-center randomized controlled study also showed that nicotinamide, a metabolite of niacin, not only reduces the blood phosphorus level in chronic hemodialysis patients but also decreases the fibroblast growth factor 23 (FGF 23) level and slows down the rate of decline of Klotho, which in turn exerts a protective effect against vascular calcification (27).