Our research team is focused on understanding mechanisms of cardiovascular disease in patients with chronic kidney disease.  We use a combination of epidemiological studies, randomized trials, patient-oriented physiological studies, and animal and in vitro work to test our hypotheses. Our primary interest is to study the role of fibroblast growth factor 23 (FGF23), a recently discovered phosphate- and vitamin D regulating hormone, in phosphate homeostasis both in health and in chronic kidney disease. Circulating levels of FGF23 rise progressively beginning early in kidney disease and are independently associated with increased risk of mortality in renal failure. Our team performs human studies of: FGF23 and clinical outcomes; FGF23 as a novel biomarker to guide earlier delivery of phosphate-related therapies in kidney patients; the effects of dietary and pharmacological interventions aimed at reducing FGF23 levels; and the potential role in health disparities of differences in dietary phosphate intake and FGF23 metabolism among racial and ethnic minorities. In addition, we perform animal and in vitro experiments to test whether FGF23 may contribute directly to organ toxicity such as in the kidney, heart, and vessels. Our ultimate goal is to translate our understanding of basic physiological mechanisms into novel therapeutic strategies that will improve the longevity and quality of life of individuals with kidney disease.