Klotho deficiency is a mediator of pathologic cardiac remodelling, and fibroblast growth factor (FGF)-23 might contribute to this process in the settings of chronic kidney disease (CKD) and ageing, conclude the authors of a new study. Hu et al. found that mice with Klotho deficiency—achieved by genetic modification, a high-phosphate diet, ageing or CKD—exhibited cardiac remodelling. FGF-23 level correlated with cardiac remodelling in Klotho-deficient but not Klotho-replete mice.