Even if endogenous PTH acts as a mild kidney vasodilator in pHPT, any protective effects would come at the cost of an increased risk of kidney calculi and it is important to stress that patients in conservative treatment would be monitored for the development of stone disease or nephrocalcinosis and that developing this complication would be a strong indication for fast-tracking them for parathyroidectomy. The gene discussed is PTH; the disease is nephrocalcinosis.