Why is calcitriol used in the treatment of chronic kidney disease (CKD)?

Calcitriol, the active form of vitamin D, plays a crucial role in managing chronic kidney disease (CKD), particularly by addressing the imbalances associated with mineral metabolism. In CKD, the kidneys are less able to convert vitamin D to its active form, leading to deficiencies that can result in secondary hyperparathyroidism. One of the key actions of calcitriol is to help regulate parathyroid hormone (PTH) levels.

In cases of CKD, there is often an overproduction of PTH in response to low calcium levels and high phosphorus levels, leading to bone disease and worsening renal function. Calcitriol works to down-regulate the production of PTH by increasing serum calcium levels and improving phosphorus control. This suppression of PTH levels helps reduce the risk of bone disease associated with CKD, thus making calcitriol a vital part of the management strategy for patients with this condition.

While other aspects of mineral and bone metabolism are also important in CKD management, the primary reason for using calcitriol lies in its ability to counteract elevated PTH levels, promoting healthier bone metabolism and overall mineral balance.