Geng S, et al. - In stage 3 and 4 chronic kidney disease (CKD; n = 5,108) individuals, experts evaluated associations between baseline serum PTH levels and following 10-year prospects of clinical fractures, vascular events, and death. In 18%, 71%, and 56% of the cohort, the occurrence of fractures, vascular events, and death, respectively, was noted. PTH was an independent predictor of fracture, vascular events, and death in univariate and multivariate models. At a baseline PTH of 0, 69, and 58 pg/mL, the hazards of fracture, vascular events and death were reduced, respectively. In conclusion, it was found that PTH was an independent predictor of fractures, vascular events, and death, among individuals with stage 3 and 4 CKD. To validate these findings, supplementary epidemiologic studies are required. If a target PTH range could be verified, then randomized placebo-controlled trials would be required to verify that treating HPT decreases the risk of fracture, vascular events, and death.