Although previous studies have shown that FGF23 could predict HF in CKD patients, to our knowledge, this is the first study to show that a higher baseline serum iFGF23 level is a strong and independent predictor of HF and cardiac deaths in asymptomatic CKD patients with preserved EF that accounts for non-cardiovascular deaths as a competing risk even after adjusting for potential confounders such as kidney function, traditional cardiovascular risk factors, echocardiographic parameters, and bone mineral biomarkers. The gene discussed is FGF23; the disease is hydrops fetalis.