In this issue of the Journal, Gutiérrez and colleaguesreport the results of a study, conducted with an efficient nestedcase–cohort design, that showed that among patients whowere beginning hemodialysis treatment, higher serum levels offibroblast growth factor 23 (FGF-23) at the initiation of dialysispredicted 1-year mortality (odds ratio for the highest vs. lowestquartile, 5.7; 95% confidence interval, 2.6 to 12.6).1 Thisassociation was independent of serum phosphate levels and otherconfounders recorded in a clinical database. This article isof interest because it concerns a subject that is at the intersectionof several important evolving areas.
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