Despite the availability of current therapeutic options, including phosphate binders and vitamin D analogs, these treatments fall short in adequately addressing the immune-mediated aspects of CKD-MBD, indicating an urgent need for innovative strategies that effectively target inflammatory pathways, inhibit sclerostin, or modulate fibroblast growth factor (FGF)-23 levels. This evidence concerns the gene FGF23 and Marchiafava-Bignami disease.