FGF23 and chronic kidney disease: These signaling cascades promote cardiomyocyte proliferation and survival, as well as angiogenesis.210 Elevated circulating FGF23 levels were also tightly associated with an increased risk of heart failure with chronic kidney disease (CKD) in a large multicenter prospective cohort study.211 Mechanistically, FGF23 attenuates phosphate reabsorption in both renal and intestinal systems.