GRHPR and chronic kidney disease: PH type 2 is caused by a pathogenic GRHPR enzyme, predominantly found in the cytosol of hepatic cells, with its activity also identified in bone marrow cells, fibroblasts, and peripheral blood lymphocytes, thus questioning liver transplant as the definitive cure [7]. According to the CRIC study, there was an independent association between higher 24-hour urine oxalate excretion (even within the normal reference range) and 32% higher risk of CKD progression [8].