The uses and abuses of Vitamin D compounds in chronic kidney disease-mineral bone disease (CKD-MBD)

Semin Nephrol. 2014 Nov;34(6):660-8. doi: 10.1016/j.semnephrol.2014.10.002.


Vitamin D is of paramount importance to skeletal development, integrity and health. Vitamin D homeostatis is typically deranged in a number of chronic conditions, of which chronic kidney disease is one of the most important. The use of vitamin D based therapy to target secondary hyperparathyroidism is now several decades old, and there is a large body of clinical practice, experience, guidelines and research to underpin this. However, there are many unknowns, of significant clinical relevance. Amongst which is what "species" of vitamin D we should be using, in what patient, and, under what conditions. Sadly, there has been a real dearth of randomised controlled trials, and trials with outputs of clinical relevance, which means our clinical practice has not developed and refined adequately ove the last 4 decades. This article will discuss the vexed but critical questions of which vitamin D therapies might suit which kidney patients, and will high-light the many important clinical questions which urgently require answering.

Keywords: LVH; Vitamin D; hypercalcemia; hyperparathyroidism.

Publication types

  • Review

MeSH terms

  • Chronic Kidney Disease-Mineral and Bone Disorder / drug therapy*
  • Chronic Kidney Disease-Mineral and Bone Disorder / etiology
  • Chronic Kidney Disease-Mineral and Bone Disorder / metabolism
  • Dietary Supplements
  • Humans
  • Hyperparathyroidism, Secondary / drug therapy*
  • Hyperparathyroidism, Secondary / etiology
  • Hyperparathyroidism, Secondary / metabolism
  • Injections, Intramuscular
  • Receptors, Calcitriol / agonists
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / metabolism
  • Ultraviolet Therapy
  • Vitamin D / analogs & derivatives
  • Vitamin D / metabolism*
  • Vitamin D / therapeutic use*


  • Receptors, Calcitriol
  • Vitamin D