PTH and Marchiafava-Bignami disease: In addition to such an assessment of the grade of appropriateness in the management of SHPT both in Italy and internationally, DOPPS data show that, in dialysis patients, there’s an increase in the risk of cardiovascular mortality and all-cause mortality associated with serum calcium levels > 10 mg/dl, phosphate levels > 7 mg/dl, and PTH levels > 600 pg/ml [8], so as to highlight how much an appropriate control of SHPT and CKD-MBD is still an unmet clinical need.