How do you choose between the different vitamin D analogs for patients with CKD, an elevated PTH, and a normal 25-hydroxy vitamin D level?

In patients with pre dialysis CKD and elevated PTH, I would recommend using ER Calcifediol, which is a 25 D compound. It has been shown to be more effective than Vit D and it does not result in hypercalcemia, hyperphosphatemia, or FGF23 as is seen with VDRAs, calcitriol, paricalcitol, or doxercalcif...

In my experience in secondary hyperparathyroidism of CKD/Pre-dialysis, Calcifediol is preferable as it addresses the iPTH without the trade-off of hypercalcemia and high phos. Cost: insurance covers can be an issue.

Up until now, I have only been using calcitriol for patients not on dialysis yet. However, I can see that if there is a concern with hypercalcemia or mainly hyperphosphatemia, doxercalciferol or paricalcitol may be slightly more preferred. In the case of hypercalcemia I believe the next best step wo...

In patients with CKD IV and below active Vitamin D like Calciltrol, Parcalciol is required than native Vitamin D like cholecalciferol. In some exagenous tissues, high-dose native vitamin D may be converted to 1:25 D3.