A 64-Year-Old Woman Comes to Her Nephrologist for a Regular

A 64-year-old woman comes to her nephrologist for a regular follow-up appointment.  The patient's medical problems include diabetes mellitus for 20 years and stage IV chronic kidney disease with a glomerular filtration rate <30 mL/min.  She takes daily insulin and has made lifestyle modifications.  Recently, her blood glucose has been well controlled.  The patient's other medical problems include hypertension and dyslipidemia, which are controlled with medication.  Her BMI is 27 kg/m².  Cardiopulmonary examination is normal.  Lower extremity examination shows trace bilateral edema and 2+ pulses.  This patient is at greatest risk for which of the following long-term complications of her renal disease?

A) Hypercalcemia
B) Hyperthyroidism
C) Hypoparathyroidism
D) Osteodystrophy
E) Retinal neovascularization