Elevated PTH is considered both a consequence and cause of the metabolic bone disorder, and it has been linked with chronic kidney disease (CKD) osteodystrophy, where high bone turnover leads to higher risk of fractures, hyperphosphatemia, vascular and tissue calcification, anemia hyporesponsive to erythropoietin therapy, worse health-related quality of life, and increased mortality [1]. The gene discussed is EPO; the disease is chronic kidney disease.