With CKD progression, there is reduced synthesis of calcitriol, a trendtowards low serum calcium levels, with increased serum of phosphorus, fibroblastgrowth factor 23 (FGF-23), resulting in a progressive increase in serum parathyroidhormone levels (PTH)6 in many patients7,8,9. The gene discussed is FGF23; the disease is chronic kidney disease.