Which form of vitamin D is primarily used in patients with CKD?

Calcitriol is the active form of vitamin D that plays a crucial role in calcium and phosphate metabolism, particularly in patients with chronic kidney disease (CKD). In CKD, the kidneys have a reduced capacity to convert vitamin D into its active form, leading to a deficiency in calcitriol. This deficiency can result in impaired mineral metabolism and contribute to complications such as secondary hyperparathyroidism.

Using calcitriol in patients with CKD helps to ensure adequate levels of active vitamin D, which is essential for promoting intestinal absorption of calcium and phosphate and maintaining bone health. It directly addresses the physiological deficiencies that CKD presents, making it the preferred choice for managing vitamin D status in these patients.

Other options, like cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2), are forms of vitamin D that require conversion in the liver and kidneys to become active, which is often ineffective in CKD patients. Likewise, 25-hydroxyvitamin D is a form that reflects vitamin D status but is not the active form that directly regulates calcium and phosphate metabolism. Therefore, calcitriol is the most appropriate choice for ensuring effective management of vitamin D-related functions in individuals with chronic kidney disease