Indeed, as shown in a recent study in children and young adults with CKD 4–5D [34], tibial cortical bone mineral density (BMD) was negatively associated with parathyroid hormone (PTH; r = − 0.44, p < 0.001) and alkaline phosphatase (ALP; r = − 0.22, p = 0.03) and positively with serum calcium (r = 0.33, p = 0.001). The gene discussed is PTH; the disease is chronic kidney disease.