Impaired vitamin D metabolism in CKD

Semin Nephrol. 2013 Mar;33(2):158-68. doi: 10.1016/j.semnephrol.2012.12.016.


Vitamin D metabolism consists of both production and catabolism, which are enzymatically driven and highly regulated. Renal vitamin D metabolism requires filtration and tubular reabsorption of 25-hydroxyvitamin D and is regulated by parathyroid hormone, fibroblast growth factor-23, and 1,25-dihydroxyvitamin D. In chronic kidney disease, renal production of 1,25-dihydroxyvitamin D from 25-hydroxyvitamin D is reduced. In addition, pharmacokinetic studies and epidemiologic studies of 24,25-dihydroxyvitamin D, the most abundant product of 25-hydroxyvitamin D catabolism by CYP24A1, suggest that vitamin D catabolism also is reduced. New insights into the mechanisms and regulation of vitamin D metabolism may lead to novel approaches to assess and treat impaired vitamin D metabolism in chronic kidney disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cytochrome P-450 Enzyme System / physiology
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / physiology
  • Glucuronidase / physiology
  • Humans
  • Klotho Proteins
  • Parathyroid Hormone / physiology
  • Renal Insufficiency, Chronic / metabolism*
  • Vitamin D / analogs & derivatives
  • Vitamin D / metabolism*


  • Parathyroid Hormone
  • Vitamin D
  • Fibroblast Growth Factors
  • 1,25-dihydroxyvitamin D
  • Fibroblast Growth Factor-23
  • Cytochrome P-450 Enzyme System
  • Glucuronidase
  • Klotho Proteins