Among all symptoms, proteinuria is the most common presentation while only 15-30% of patients with renal symptoms develop end-stage renal disease.5,7 In our case, the patient had a nephrotic range of proteinuria, generalised body swelling, raised blood urea/creatinine, decreased urine output, increased intact parathyroid hormone, and anaemia suggesting chronic kidney disease requiring renal replacement therapy. Here, PTH is linked to anemia (phenotype).