Through multi-center randomized controlled trial studies on preemptive surgical intervention in patients with chronic kidney disease (CKD) - secondary hyperparathyroidism (SHPT), to precisely evaluate the safety and effectiveness during perioperative period, and the long-term outcomes by 1-year follow-up. The follow-ups include the evaluation of the overall quality of life, calcium and phosphorus metabolism, hyperparathyroidism level, vitamin D metabolism, bone mineral density, soft tissue and vascular calcification.

Inclusion Criteria:

• 1) Chronic Kidney Disease Stage 3-5d patients aged ≥18 years;
• 2) The diagnosis is consistent with CKD-metabolic bone disease and SHPT after evaluation by a kidney specialist;
• 3) Sustained blood immunoreactive parathyroid hormone level of > 300ng/ml, and had received drug treatment;
• 4) Persistent hypercalcemia and/or hyperphosphatemia that is not responding to medication;
• 5) Imaging suggested evidence of at least one parathyroid nodular hyperplasia;
• 6) Signed the informed consent.

Exclusion Criteria:

• 1) Age <18 years old;
• 2) Patients with dialysis duration < 3 months, or with other unstable dialysis state;
• 3) Kidney transplant patients;
• 4) Who is considered inappropriate to participate in this study after evaluation by the supervising physician.

CKD 3-5d patients with the diagnosis of CKD-metabolic bone disease and SHPT, with sustained blood immunoreactive parathyroid hormone level of > 300ng/ml, and persistent hypercalcemia and/or hyperphosphatemia, which are not responding to medication.