PTH and chronic kidney disease: In adult patients with CKD stages G3a-G5 who are not on dialysis, AVD and analogs are not recommended for routine use, while it has been suggested to reserve their utilization for patients with CKD stages G4-G5 with severe and progressive sHPT and to modulate their administration on the basis of serial measurements of phosphate, calcium, and PTH levels [19,20,21].