In general, sHPT is more severe in Black compared with White patients, a disparity that may reflect biological differences in calcium and parathyroid hormone signaling, inadequate control of sHPT, longer duration of undiagnosed kidney disease, younger age at ESKD onset, and reduced access to transplantation.20,21,32 Alternatively, Black and Hispanic patients could have benefited most from TDAPA through removal of cost-sharing barriers or moving calcimimetic administration from pharmacies to dialysis centers, as noted previously. This evidence concerns the gene PTH and kidney disorder.