The serum level of the protein Klotho is not only a marker for the severity of CKD and its complications (anemia, left ventricular hypertrophy, and heart failure), but also a pathogenetic factor of CKD progression. Anemia correction with erythropoiesis stimulants has been shown to enhance the renal and extrarenal production of α-Klotho.

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The review considers the current views of the mechanisms of hyperphosphatemia in patients with chronic renal failure. It shows indications for the use of different classes of phosphate-binding drugs to correct hyperphosphatemia.