Spoto B, et al. - Researchers examined chronic kidney disease (CKD) patients to analyze static (baseline adiponectin levels) and dynamic (fluctuations in adiponectin levels) interactions of serum adiponectin with the FGF23 response to paricalcitol and placebo. They found that FGF23 response to VDR activation in CKD patients was strongly altered by adiponectin. Paricalcitol- vs placebo-induced VDR activation noticeably increased serum FGF23 levels, and patients in the 4th adiponectin quartile showed an even larger increase vs other quartiles, while no such effect was seen in the placebo group. In the FGF23 response to VDR activation in CKD patients, mechanistic relevance of the adiponectin–FGF23 link (discovered in genetically engineered mice) was suggested.