Given scenario suggests the diagnosis of teiary hyperparathyroidism- commonly seen in patients with chronic kidney disease who are poorly compliant with therapy. Features- bone pain, ectopic calcification & pruritus. Hypoxemia and ground-glass infiltrates on chest CT represent ectopic calcification of the lungs. A technetium-99 bone scan will show increased uptake in the lungs. Lab- Elevated calcium, phosphates & PTH levels Rx- Parathyroidectomy is done in this patient because of severe clinical manifestations.