The receptor activator of nuclear factor-κB ligand (RANKL)/receptor activator of nuclear factor-Kb (RANK)/osteoprotegerin (OPG) axis is a cornerstone of bone remodeling, and its dysregulation in CKD-MBD significantly contributes to bone resorption. This evidence concerns the gene TNFRSF11A and Marchiafava-Bignami disease.