Vitamin D: an important treatment for secondary hyperparathyroidism in chronic kidney disease?

Secondary hyperparathyroidism (SHPT) is one of the most common complications of chronic kidney disease (CKD). Vitamin D levels begin to decrease in the early stages of CKD, and these vitamin D-related changes play a central role in the occurrence and development of SHPT. Vitamin D-based drugs, which inhibit parathyroid hormone secretion either directly or indirectly, are commonly used to treat SHPT. However, vitamin D-based drugs can also lead to a dysregulated balance between serum calcium and phosphorus, as well as other adverse reactions. Over the past several decades, researchers have conducted in-depth studies on the pathogenesis of SHPT, developed new vitamin D-based drugs, and explored combinatory methods to improve treatment efficacy for the disease. Here, we review vitamin D metabolism, the diagnosis of vitamin D deficiency in patients with CKD, the pathogenesis of SHPT, the pharmacological effects of vitamin D drugs, and the benefits and side effects of using vitamin D to treat SHPT.