Etiology of this patient’s osteoporosis?

A 32-year-old female dialysis patient visits her general internist for a health maintenance visit. She subsequently has a dual-energy x-ray absorption examination, which demonstrates significant osteoporosis. What is the most likely
etiology of this patient’s osteoporosis?

(A) 1,25-Dihydroxycholecalciferol excess
(B) Chronic metabolic alkalosis
© Hypercalcemia
(D) Hypophosphatemia
(E) Secondary hyperparathyroidism