Which of the following can induce secondary hyperparathyroidism?

Secondary hyperparathyroidism occurs when the parathyroid glands are stimulated to produce excess parathyroid hormone (PTH) due to low levels of calcium or vitamin D, or increased phosphate levels. In chronic kidney disease (CKD), there is a decrease in the kidneys' ability to excrete phosphate, leading to hyperphosphatemia. The elevated phosphate can bind to calcium, resulting in hypocalcemia. This ultimately triggers the parathyroid glands to increase PTH secretion in an effort to normalize calcium levels, resulting in secondary hyperparathyroidism.

This situation contrasts with primary hyperparathyroidism, which is characterized by autonomous overproduction of PTH regardless of calcium levels. Osteitis fibrosa cystica is a consequence of primary hyperparathyroidism rather than a cause of secondary hyperparathyroidism. Paget’s disease is primarily associated with disorganized bone remodeling and does not induce secondary hyperparathyroidism; instead, it can sometimes lead to normal or decreased PTH levels since bones are affected differently in this pathology. Therefore, chronic kidney disease is the correct answer due to its role in altering mineral metabolism and stimulating parathyroid hormone release in response to those imbalances.