OBJECTIVE: Aim: This study aimed to evaluate the serum levels of key biomarkers, including parathyroid hormone (PTH), vitamin D3, calcium, phosphate, and renal function tests (RFTS), in patients with chronic renal failure over three years.. PATIENTS AND METHODS: Materials and Methods: A cohort of 83 patients with chronic renal failure and 70 healthy controls were followed, with data collected at one, two, and three years. RESULTS: Results: Significant differences were observed in the levels of creatinine, urea, phosphate, calcium, vitamin D, and parathyroid hormone between patients and controls. the study found a progressive increase in phosphate and parathyroid hormone levels, alongside a decrease in calcium and vitamin D levels in patients over time. strong correlations were observed between these biomarkers, highlighting the complex interplay between mineral metabolism and renal function in chronic renal failure. CONCLUSION: Conclusions: These findings confirm the need for integrated management strategies to address these biochemical disturbances and improve the life quality of patients with chronic renal failure.