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The FDA has approved extended-release (ER) calcifediol (25-hydroxyvitamin D3; Rayaldee – Opko), a prohormone of calcitriol, the active form of vitamin D3. It is indicated for treatment of secondary hyperparathyroidism (SHPT) in adults with stage 3 or 4 chronic kidney disease (CKD) who have serum total 25-hydroxyvitamin D levels <30 ng/mL.
TREATMENT OF SHPT — Secondary hyperparathyroidism is a common complication of CKD; it develops in response to declining renal function, impaired phosphate excretion, and the inability of the kidneys to convert vitamin D to calcitriol (1,25-dihydroxyvitamin D3). Reduced synthesis of calcitriol leads to low levels of serum calcium and elevated levels of serum phosphorus, which results in increased parathyroid hormone (PTH) secretion.1
Nutritional (inactive) vitamin D is effective in repleting vitamin D stores, but it... more
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