Prior to my first Prolia injection my D was 9....This has been an ongoing problem for me....I take the prescribed megadoses followed by maintenance recommendations.....I had a surgical menopause at age 29.... My osteoporosis is severe. My rheumatologist plans to recheck my PTH and GFR in a few weeks....He says not to worry...I was the one who had to bring his attention to the significant decrease in the glomerular filtration rate...I have not been to an endocrinologist yet, but pending my recheck, I will request a referral....I have no idea how long my PTH has been elevated; I know only for the last year and a half by virtue of testing.....NOTHING in my lifestyle has changed...I take an ACE INHIBITOR, plus my maintenance dose ov D3 and calcium petites.. I FEEL IT IS PROLIA....I will not sacrifice my kidneys....I am ambulatory and will continue to walk daily as always...I will post more when I have more facts...We all must remain healthy and informed...