There are some theories that outcomes for ESRD patients are different according to findings related to CKD-MBD, such as serum levels of FGF-23 and the presence or severity of vascular calcifications; however, it is generally hypothesized that the benefits observed with early interventions depend on how early risk is detected and addressed [11]. This evidence concerns the gene FGF23 and Marchiafava-Bignami disease.