The relationship between vitamin D, chronic kidney disease, and mineral and bone disorder: a complex interplay comprehensive review

Chronic kidney disease (CKD) is a global health concern with a significant prevalence. One major complication of CKD is mineral and bone disorder (MBD), characterized by abnormalities in calcium, phosphate, and parathyroid hormone (PTH) levels, leading to bone mineral density loss and increased fracture risk. Vitamin D deficiency is highly prevalent in CKD patients due to impaired kidney function and reduced sun exposure. This deficiency further contributes to CKD-MBD pathogenesis. This review explores the complex interplay between Vitamin D, CKD, and MBD. We examine how CKD disrupts Vitamin D metabolism, leading to deficiency and its consequences for bone health and mineral homeostasis. We critically evaluate the current evidence on Vitamin D supplementation in CKD, focusing on its impact on bone mineral density (BMD), fracture risk, calcium, phosphate, and PTH levels. We discuss the limitations of existing research and highlight the need for further studies to establish definitive recommendations for Vitamin D management in CKD-MBD treatment strategies.