Which of the following is true regarding chronic kidney disease?

Chronic kidney disease (CKD) is characterized by a gradual loss of kidney function over time, and one of its significant long-term complications is indeed secondary hyperparathyroidism. As the kidneys fail to filter blood effectively, they struggle to excrete phosphate, leading to hyperphosphatemia. Elevated phosphate levels in the bloodstream stimulate the parathyroid glands to secrete more parathyroid hormone (PTH) in an effort to maintain calcium and phosphate balance. This compensatory mechanism leads to secondary hyperparathyroidism, where the level of parathyroid hormone remains elevated due to the ongoing disruption in calcium and phosphate handling.

In contrast, chronic kidney disease typically does not present with an acute onset of symptoms; rather, it develops insidiously over months or years. While blood pressure can be affected in patients with CKD, it is not uniformly true that all patients will have hypertension. Anuria, which refers to the absence of urine production, is more commonly associated with acute kidney injury rather than CKD, where patients usually experience a gradual decrease in urine output. These other choices fail to reflect the true progression and systemic effects of chronic kidney disease, highlighting why secondary hyperparathyroidism is the correct and relevant consequence of this condition.