The treatment effect we observed for cinacalcet on fracture (RR, 0.53) was similar in magnitude to, but less certain than, the risk estimate observed in a pooled analysis of four similarly designed randomized, double-blind, placebo-controlled trials of cinacalcet enrolling 1,184 participants with CKD stage 5D and intact PTH concentrations of 300 ng/l or more, in which the RR of fracture was 0.46 (95% CI, 0.22–0.95) [18]. This evidence concerns the gene PTH and chronic kidney disease.