A 64-year-old woman comes to the physician for a routine health maintenance examination. She has type II diabetes and hypertension managed with metformin and lisinopril. Blood pressure is 135/85. Serum creatinine is 1.2 mg/dL. Urinary protein is 1+. Her serum parathyroid hormone (PTH) and calcium are represented by the magenta dot on the following graph. Which of the following is the most likely diagnosis in this patient?
Early renal insufficiency
Metastatic malignancy
Paget disease
Sarcoidosis
Tertiary hyperparathyroidism
