Owing to the availability of new molecules for medical therapy, the indications for PTx could be reduced to the following: (1) hyperparathyroidism resistant to calcimimetic administration, (2) severe refractory hyperphosphatemia, (3) severe hyperparathyroidism in dialysis without response to medical treatment, (4) cases of calciphylaxis with PTH levels above 500 pg/mL that do not rapidly respond to calcimimetics, (5) complications derived from SHPT, and (6) primary hyperparathyroidism in patients with CKD59. Here, PTH is linked to hyperphosphatemia.