PTH and stage 5 chronic kidney disease: The disease generally presents with painful skin ulcers and necrosis as its primary manifestations.1 Studies have shown that the disease can carry a mortality rate ranging from 33% to 80%.2 The pathophysiology involves the accumulation of calcium in the skin, vascular space, and adipose tissue due to abnormal serum levels of calcium, phosphorus, and parathyroid hormone (PTH), particularly in patients with end-stage renal disease (ESRD), a condition known as calcific uremic arteriolopathy (CUA).