PTH and Hypocalcemia: In CKD patients not requiring dialysis, randomized‐controlled trials of cinacalcet have reported significant reductions in FGF23, but also poor suppression of PTH as well as high rates of hypocalcemia and hyperphosphatemia.173, 174 These actions are thought to negate many of the clinical benefits of calcimimetics and these agents are not licensed for use in patients with non‐end‐stage CKD.