In advanced stages of CKD, more than 80% of patients with a glomerular filtration rate below 20 ml/min/1.73 m2 show elevated parathyroid hormone (PTH) levels, and up to 54% of end-stage renal disease patients present with some degree of hyperparathyroidism, potentially progressing to THPT if inadequately treated (3–6). Here, PTH is linked to stage 5 chronic kidney disease.