OBJECTIVES: Health economic evaluations of therapeutic interventions in patients with CKD and SHPT requiring dialysis (CKD-SHPT) should incorporate the impact of major clinical events related to their disease.  However, little is known about the disutility (i.e, utility decrease) associated with cardiovascular (CV) and fracture events in the context of CKD-SHPT.  The purpose of this study was to estimate, via preference-based valuation completed by general population respondents, the added disutility of these events beyond the impact of CKD-SHPT. METHODS: One-year health states were developed describing CKD-SHPT and related CV/fracture acute events/procedures.  Events with long-term effects (post one year) were also captured in chronic health states.  General population participants in Canada completed time trade-off (TTO) interviews to assess health state utilities.  Respondents initially rated the CKD-SHPT health state.  Then, events and procedures were added to this health state: myocardial infarction (MI); unstable angina (UA); heart failure exacerbation; peripheral vascular disease (PVD) ± amputation; stable angina (SA); stroke; hip/arm fractures; parathyroidectomy; kidney transplant.  Each participant was randomly-assigned 11 of 16 health states to rate.  RESULTS: A total of 199 participants (54.8% female; mean age = 46.3 years) completed interviews. Each health state had ≥130 valuations. CKD-SHPT had a mean utility of 0.60 (SD=0.34).  For acute events, mean utility decrements additional to CKD-SHPT were: MI, -0.06; UA, -0.05; PVD with amputation, -0.33; PVD without amputation, -0.11; heart failure, -0.14; stroke -0.30; hip fracture, -0.14; arm fracture, -0.04; parathyroidectomy, +0.02; kidney transplant, +0.06.  Disutilities for chronic effects were: SA, -0.09; stroke -0.27; PVD with amputation -0.30; PVD without amputation, -0.12; heart failure, -0.14. CONCLUSIONS: Valuation of health states representing CKD-SHPT plus major clinical events was feasible using TTO with a one-year time horizon.  These data will assist investigators in applying appropriate disutilities to clinical events in economic evaluations of treatments for patients with CKD-SHPT requiring dialysis.