Disorders Of Calcium And Phosphate Metabolism Practice Test

Why is vitamin D status important in managing CKD-MBD?

It is not relevant to bone turnover It primarily affects phosphate excretion It should be kept at high excess to promote calcium absorption It influences PTH, bone turnover, and calcium/phosphate balance

Correct Answer:

It influences PTH, bone turnover, and calcium/phosphate balance

Explanation:

Vitamin D status influences how much calcium is absorbed from the gut, how much parathyroid hormone (PTH) the body releases, and how bones are remodeled. In CKD, the kidneys lose the ability to activate vitamin D, leading to reduced intestinal calcium absorption and often low serum calcium. That drop stimulates PTH production, driving secondary hyperparathyroidism and increased bone turnover, which contributes to renal osteodystrophy. Maintaining adequate vitamin D (or giving active forms when needed) helps suppress PTH synthesis, supports proper bone mineralization, and helps balance calcium and phosphate levels. Because of these intertwined effects on PTH, bone turnover, and mineral balance, vitamin D status is central to managing CKD-MBD.

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