Management must therefore integrate targeted metabolic and cardiovascular measures—rigorous blood-pressure control, correction of anemia, treatment of dyslipidemia—alongside therapies directed at mineral metabolism, including vitamin D analogues, calcimimetics (cinacalcet, etelcalcetide, upacicalcet) and phosphate-lowering strategies; these interventions can favorably modify PTH levels, parathyroid gland volume and bone structure, but require careful monitoring for hypocalcemia and vascular calcification. This evidence concerns the gene PTH and anemia (phenotype).