porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo13197porozendo-13197Research ArticleНАУЧНЫЕ ОБЗОРЫREVIEWSОсобенности метаболизма витамина D и регуляции кальций-фосфорного обмена у пациентов с хронической болезнью почекVitamin D metabolism and regulation of calciumphosphorus homeostasis in patients with chronic kidney diseasehttps://orcid.org/0009-0007-0513-498XБондаренкоА. С.BondarenkoA. S.

Бондаренко Аксения Сергеевна

117292, Москва, ул. Дм. Ульянова, д. 11

Axenia S. Bondarenko, MD

11 Dm.Ulyanova street, 117292 Moscow

axenia.bondarenko@gmail.comhttps://orcid.org/0000-0001-7041-0732РожинскаяЛ. Я.RozhinskayaL. Ya.

Рожинская Людмила Яковлевна, д.м.н., профессор

117292, Москва, ул. Дм. Ульянова, д. 11

Liudmila Ya. Rozhinskaya, MD, PhD, Professor

11 Dm.Ulyanova street, 117292 Moscow

lrozhinskaya@gmail.comhttps://orcid.org/0000-0002-2729-9386ЖуковА. Ю.ZhukovA. Yu.

Жуков Артем Юрьевич

117292, Москва, ул. Дм. Ульянова, д. 11

Artem Yu. Zhukov, MD

11 Dm.Ulyanova street, 117292 Moscow

zhukovartem@yahoo.comhttps://orcid.org/0000-0002-6674-6441БелаяЖ. Е.BelayaZh. E.

Белая Жанна Евгеньевна, д.м.н.

117292, Москва, ул. Дм. Ульянова, д. 11

Zhanna E. Belaya, MD, PhD

11 Dm.Ulyanova street, 117292 Moscow

jannabelaya@gmail.comhttps://orcid.org/0000-0002-5634-7877МельниченкоГ. А.MelnichenkoG. A.

Мельниченко Галина Афанасьевна, д.м.н., профессор

117292, Москва, ул. Дм. Ульянова, д. 11

Galina A. Melnichenko, MD, PhD, Professor

11 Dm.Ulyanova street, 117292 Moscow

teofrast2000@mail.ruФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава РоссииРоссияEndocrinology Research CentreRussian Federation2025170520252812837Copyright © Бондаренко А.С., Рожинская Л.Я., Жуков А.Ю., Белая Ж.Е., Мельниченко Г.А., 20252025Бондаренко А.С., Рожинская Л.Я., Жуков А.Ю., Белая Ж.Е., Мельниченко Г.А.Bondarenko A.S., Rozhinskaya L.Y., Zhukov A.Y., Belaya Z.E., Melnichenko G.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/13197

Хроническая болезнь почек (ХБП) сопровождается значительными нарушениями минерального обмена и метаболизма витамина D, что приводит к развитию минеральных и костных нарушений (МКН-ХБП) и увеличению риска сердечно-сосудистых осложнений, переломов и смертности. В настоящей статье рассмотрены механизмы регуляции кальций-фосфорного обмена и метаболизма витамина D в норме и при ХБП, включая влияние паратиреоидного гормона (ПТГ), фактора роста фибробластов-23 (ФРФ-23) и α-Klotho. Обсуждаются современные подходы к лабораторной диагностике и целевые уровни параметров минерального обмена у пациентов с ХБП, а также перспективы применения новых биомаркеров, таких как соотношение 24,25(OH)2D/25(OH)D (VMR) и 1,24,25(OH)3D/1,25(OH)2D (1,25VMR). Представленный обзор подчеркивает необходимость дальнейших исследований для оптимизации диагностики и лечения минеральных нарушений у пациентов с ХБП.

Chronic kidney disease (CKD) is associated with significant disturbances in mineral and vitamin D metabolism, leading to the development of CKD-related mineral and bone disorders (CKD-MBD) and an increased risk of cardiovascular complications, fractures, and mortality. This paper reviews the mechanisms of calcium-phosphorus homeostasis and vitamin D metabolism regulation in CKD, focusing also on the roles of parathyroid hormone (PTH), fibroblast growth factor-23 (FGF-23) and the Klotho protein. Modern approaches to laboratory diagnostics and target mineral parameters in CKD patients are discussed, as well as the potential use of novel biomarkers, such as the 24,25(OH)2D/25(OH)D ratio (VMR) and 1,24,25(OH)3D/1,25(OH)2D ratio (1,25VMR). This review highlights the need for further research to optimize the diagnosis and treatment of mineral disturbances in CKD patients.

витамин Dкальций-фосфорный обменхроническая болезнь почекМКН-ХБП125(OH)2D2425(OH)2D12425(OH)3DФРФ-23vitamin Dcalcium-phosphorus metabolismchronic kidney diseaseCKD-MBD125(OH)2D2425(OH)2D12425(OH)3DFGF-23Государственное задание №НИОКТР 124020700097-8 при поддержке Министерства здравоохранения Российской Федерации.ReferencesКлинические рекомендации Министерства здравоохранения Российской Федерации «Хроническая болезнь почек». — 2024. — Текст: электронный // Рубрикатор клинических рекомендаций: сайт. — URL: https://cr.minzdrav.gov.ru/viewcr/469_3 (дата обращения: 10.02.2025).Klinicheskie rekomendacii Ministerstva zdravoohraneniya Rossijskoj Federacii «Hronicheskaya bolezn’ pochek». 2024. Tekst: elektronnyj. Rubrikator klinicheskih rekomendacij: sajt. (In Russ.).Francis A, Harhay MN, Ong ACM, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol. 2024;20(7):473-485. doi: https://doi.org/10.1038/s41581-024-00820-6Francis A, Harhay MN, Ong ACM, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol. 2024;20(7):473-485. doi: https://doi.org/10.1038/s41581-024-00820-6Moe S, Drüeke T, Cunningham J, et al. Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69(11):1945-1953. doi: https://doi.org/10.1038/sj.ki.5000414Moe S, Drüeke T, Cunningham J, et al. Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69(11):1945-1953. doi: https://doi.org/10.1038/sj.ki.5000414Abdalbary M, Sobh M, Elnagar S, et al. Management of osteoporosis in patients with chronic kidney disease. Osteoporosis International. 2022;33(11):2259-2274. doi: https://doi.org/10.1007/s00198-022-06462-3Abdalbary M, Sobh M, Elnagar S, et al. Management of osteoporosis in patients with chronic kidney disease. Osteoporosis International. 2022;33(11):2259-2274. doi: https://doi.org/10.1007/s00198-022-06462-3Yamada S, Nakano T. Role of Chronic Kidney Disease (CKD)–Mineral and Bone Disorder (MBD) in the Pathogenesis of Cardiovascular Disease in CKD. J Atheroscler Thromb. 2023;30(8):RV22006. doi: https://doi.org/10.5551/jat.RV22006Yamada S, Nakano T. Role of Chronic Kidney Disease (CKD)–Mineral and Bone Disorder (MBD) in the Pathogenesis of Cardiovascular Disease in CKD. J Atheroscler Thromb. 2023;30(8):RV22006. doi: https://doi.org/10.5551/jat.RV22006Luo L, Chen Q. Effect of CKD–MBD phenotype on health-related quality of life in patients receiving maintenance hemodialysis: A cross-sectional study. Journal of International Medical Research. 2020;48(2). doi: https://doi.org/10.1177/0300060519895844Luo L, Chen Q. Effect of CKD–MBD phenotype on health-related quality of life in patients receiving maintenance hemodialysis: A cross-sectional study. Journal of International Medical Research. 2020;48(2). doi: https://doi.org/10.1177/0300060519895844Magagnoli L, Cozzolino M, Caskey FJ, et al. Association between CKD-MBD and mortality in older patients with advanced CKD—results from the EQUAL study. Nephrology Dialysis Transplantation. 2023;38(11):2562-2575. doi: https://doi.org/10.1093/ndt/gfad100Magagnoli L, Cozzolino M, Caskey FJ, et al. Association between CKD-MBD and mortality in older patients with advanced CKD—results from the EQUAL study. Nephrology Dialysis Transplantation. 2023;38(11):2562-2575. doi: https://doi.org/10.1093/ndt/gfad100Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral Metabolism, Mortality, and Morbidity in Maintenance Hemodialysis. Journal of the American Society of Nephrology. 2004;15(8):2208-2218. doi: https://doi.org/10.1097/01.ASN.0000133041.27682.A2Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral Metabolism, Mortality, and Morbidity in Maintenance Hemodialysis. Journal of the American Society of Nephrology. 2004;15(8):2208-2218. doi: https://doi.org/10.1097/01.ASN.0000133041.27682.A2Raue F, Haag C, Schulze E, Frank-Raue K. The Role of the Extracellullar Calcium-Sensing Receptor in Health and Disease. Experimental and Clinical Endocrinology & Diabetes. 2006;114(08):397-405. doi: https://doi.org/10.1055/s-2006-924315Raue F, Haag C, Schulze E, Frank-Raue K. The Role of the Extracellullar Calcium-Sensing Receptor in Health and Disease. Experimental and Clinical Endocrinology & Diabetes. 2006;114(08):397-405. doi: https://doi.org/10.1055/s-2006-924315Murray SL, Wolf M. Calcium and Phosphate Disorders: Core Curriculum 2024. American Journal of Kidney Diseases. 2024;83(2):241-256. doi: https://doi.org/10.1053/j.ajkd.2023.04.017Murray SL, Wolf M. Calcium and Phosphate Disorders: Core Curriculum 2024. American Journal of Kidney Diseases. 2024;83(2):241-256. doi: https://doi.org/10.1053/j.ajkd.2023.04.017Quarles LD. Fibroblast growth factor 23 and α-Klotho co-dependent and independent functions. Curr Opin Nephrol Hypertens. 2019;28(1):16-25. doi: https://doi.org/10.1097/MNH.0000000000000467Quarles LD. Fibroblast growth factor 23 and α-Klotho co-dependent and independent functions. Curr Opin Nephrol Hypertens. 2019;28(1):16-25. doi: https://doi.org/10.1097/MNH.0000000000000467Prabhu A V, Luu W, Li D, Sharpe LJ, Brown AJ. DHCR7: A vital enzyme switch between cholesterol and vitamin D production. Prog Lipid Res. 2016;64:138-151. doi: https://doi.org/10.1016/j.plipres.2016.09.003Prabhu A V, Luu W, Li D, Sharpe LJ, Brown AJ. DHCR7: A vital enzyme switch between cholesterol and vitamin D production. Prog Lipid Res. 2016;64:138-151. doi: https://doi.org/10.1016/j.plipres.2016.09.003Prabhu A V, Luu W, Sharpe LJ, Brown AJ. Cholesterol-mediated Degradation of 7-Dehydrocholesterol Reductase Switches the Balance from Cholesterol to Vitamin D Synthesis. Journal of Biological Chemistry. 2016;291(16):8363-8373. doi: https://doi.org/10.1074/jbc.M115.699546Prabhu A V, Luu W, Sharpe LJ, Brown AJ. Cholesterol-mediated Degradation of 7-Dehydrocholesterol Reductase Switches the Balance from Cholesterol to Vitamin D Synthesis. Journal of Biological Chemistry. 2016;291(16):8363-8373. doi: https://doi.org/10.1074/jbc.M115.699546Wacker M, Holick MF. Sunlight and Vitamin D. Dermatoendocrinol. 2013;5(1):51-108. doi: https://doi.org/10.4161/derm.24494Wacker M, Holick MF. Sunlight and Vitamin D. Dermatoendocrinol. 2013;5(1):51-108. doi: https://doi.org/10.4161/derm.24494Jäpelt RB, Jakobsen J. Vitamin D in plants: a review of occurrence, analysis, and biosynthesis. Front Plant Sci. 2013;4. doi: https://doi.org/10.3389/fpls.2013.00136Jäpelt RB, Jakobsen J. Vitamin D in plants: a review of occurrence, analysis, and biosynthesis. Front Plant Sci. 2013;4. doi: https://doi.org/10.3389/fpls.2013.00136Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, editors. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025.Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, editors. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025.Borel P, Caillaud D, Cano NJ. Vitamin D Bioavailability: State of the Art. Crit Rev Food Sci Nutr. 2015;55(9):1193-1205. doi: https://doi.org/10.1080/10408398.2012.688897Borel P, Caillaud D, Cano NJ. Vitamin D Bioavailability: State of the Art. Crit Rev Food Sci Nutr. 2015;55(9):1193-1205. doi: https://doi.org/10.1080/10408398.2012.688897Rosenstreich SJ, Rich C, Volwiler W. Deposition in and release of vitamin D3 from body fat: evidence for a storage site in the rat. Journal of Clinical Investigation. 1971;50(3):679-687. doi: https://doi.org/10.1172/JCI106538Rosenstreich SJ, Rich C, Volwiler W. Deposition in and release of vitamin D3 from body fat: evidence for a storage site in the rat. Journal of Clinical Investigation. 1971;50(3):679-687. doi: https://doi.org/10.1172/JCI106538Abboud M, Puglisi DA, Davies BN, et al. Evidence for a Specific Uptake and Retention Mechanism for 25-Hydroxyvitamin D (25OHD) in Skeletal Muscle Cells. Endocrinology. 2013;154(9):3022-3030. doi: https://doi.org/10.1210/en.2012-2245Abboud M, Puglisi DA, Davies BN, et al. Evidence for a Specific Uptake and Retention Mechanism for 25-Hydroxyvitamin D (25OHD) in Skeletal Muscle Cells. Endocrinology. 2013;154(9):3022-3030. doi: https://doi.org/10.1210/en.2012-2245Bikle DD. Vitamin D Metabolism, Mechanism of Action, and Clinical Applications. Chem Biol. 2014;21(3):319-329. doi: https://doi.org/10.1016/j.chembiol.2013.12.016Bikle DD. Vitamin D Metabolism, Mechanism of Action, and Clinical Applications. Chem Biol. 2014;21(3):319-329. doi: https://doi.org/10.1016/j.chembiol.2013.12.016Cheng JB, Motola DL, Mangelsdorf DJ, Russell DW. De-orphanization of Cytochrome P450 2R1. Journal of Biological Chemistry. 2003;278(39):38084-38093. doi: https://doi.org/10.1074/jbc.M307028200Cheng JB, Motola DL, Mangelsdorf DJ, Russell DW. De-orphanization of Cytochrome P450 2R1. Journal of Biological Chemistry. 2003;278(39):38084-38093. doi: https://doi.org/10.1074/jbc.M307028200Strushkevich N, Usanov SA, Plotnikov AN, Jones G, Park HW. Structural Analysis of CYP2R1 in Complex with Vitamin D3. J Mol Biol. 2008;380(1):95-106. doi: https://doi.org/10.1016/j.jmb.2008.03.065Strushkevich N, Usanov SA, Plotnikov AN, Jones G, Park HW. Structural Analysis of CYP2R1 in Complex with Vitamin D3. J Mol Biol. 2008;380(1):95-106. doi: https://doi.org/10.1016/j.jmb.2008.03.065Alonso N, Zelzer S, Eibinger G, Herrmann M. Vitamin D Metabolites: Analytical Challenges and Clinical Relevance. Calcif Tissue Int. 2022;112(2):158-177. doi: https://doi.org/10.1007/s00223-022-00961-5Alonso N, Zelzer S, Eibinger G, Herrmann M. Vitamin D Metabolites: Analytical Challenges and Clinical Relevance. Calcif Tissue Int. 2022;112(2):158-177. doi: https://doi.org/10.1007/s00223-022-00961-5Bailie GR, Johnson CA. Comparative Review of the Pharmacokinetics of Vitamin D Analogues. Semin Dial. 2002;15(5):352-357. doi: https://doi.org/10.1046/j.1525-139X.2002.00086.xBailie GR, Johnson CA. Comparative Review of the Pharmacokinetics of Vitamin D Analogues. Semin Dial. 2002;15(5):352-357. doi: https://doi.org/10.1046/j.1525-139X.2002.00086.xTakeyama Kichi, Kitanaka S, Sato T, Kobori M, Yanagisawa J, Kato S. 25-Hydroxyvitamin D 3 1α-Hydroxylase and Vitamin D Synthesis. Science (1979). 1997;277(5333):1827-1830. doi: https://doi.org/10.1126/science.277.5333.1827Takeyama Kichi, Kitanaka S, Sato T, Kobori M, Yanagisawa J, Kato S. 25-Hydroxyvitamin D 3 1α-Hydroxylase and Vitamin D Synthesis. Science (1979). 1997;277(5333):1827-1830. doi: https://doi.org/10.1126/science.277.5333.1827Fraser DR, Kodicek E. Unique Biosynthesis by Kidney of a Biologically Active Vitamin D Metabolite. Nature. 1970;228(5273):764-766. doi: https://doi.org/10.1038/228764a0Fraser DR, Kodicek E. Unique Biosynthesis by Kidney of a Biologically Active Vitamin D Metabolite. Nature. 1970;228(5273):764-766. doi: https://doi.org/10.1038/228764a0Nykjaer A, Dragun D, Walther D, et al. An Endocytic Pathway Essential for Renal Uptake and Activation of the Steroid 25-(OH) Vitamin D3. Cell. 1999;96(4):507-515. doi: https://doi.org/10.1016/S0092-8674(00)80655-8Nykjaer A, Dragun D, Walther D, et al. An Endocytic Pathway Essential for Renal Uptake and Activation of the Steroid 25-(OH) Vitamin D3. Cell. 1999;96(4):507-515. doi: https://doi.org/10.1016/S0092-8674(00)80655-8Liu, Yu, Carling, et al. Regulation of gp330/megalin expression by vitamins A and D. Eur J Clin Invest. 1998;28(2):100-107. doi: https://doi.org/10.1046/j.1365-2362.1998.00253.xLiu, Yu, Carling, et al. Regulation of gp330/megalin expression by vitamins A and D. Eur J Clin Invest. 1998;28(2):100-107. doi: https://doi.org/10.1046/j.1365-2362.1998.00253.xAdams JS, Sharma OP, Gacad MA, Singer FR. Metabolism of 25-hydroxyvitamin D3 by cultured pulmonary alveolar macrophages in sarcoidosis. Journal of Clinical Investigation. 1983;72(5):1856-1860. doi: https://doi.org/10.1172/JCI111147Adams JS, Sharma OP, Gacad MA, Singer FR. Metabolism of 25-hydroxyvitamin D3 by cultured pulmonary alveolar macrophages in sarcoidosis. Journal of Clinical Investigation. 1983;72(5):1856-1860. doi: https://doi.org/10.1172/JCI111147Bikle DD, Patzek S, Wang Y. Physiologic and pathophysiologic roles of extra renal CYP27b1: Case report and review. Bone Rep. 2018;8:255-267. doi: https://doi.org/10.1016/j.bonr.2018.02.004Bikle DD, Patzek S, Wang Y. Physiologic and pathophysiologic roles of extra renal CYP27b1: Case report and review. Bone Rep. 2018;8:255-267. doi: https://doi.org/10.1016/j.bonr.2018.02.004Jones G, Prosser DE, Kaufmann M. 25-Hydroxyvitamin D-24-hydroxylase (CYP24A1): Its important role in the degradation of vitamin D. Arch Biochem Biophys. 2012;523(1):9-18. doi: https://doi.org/10.1016/j.abb.2011.11.003Jones G, Prosser DE, Kaufmann M. 25-Hydroxyvitamin D-24-hydroxylase (CYP24A1): Its important role in the degradation of vitamin D. Arch Biochem Biophys. 2012;523(1):9-18. doi: https://doi.org/10.1016/j.abb.2011.11.003Prosser DE, Kaufmann M, O’Leary B, Byford V, Jones G. Single A326G mutation converts human CYP24A1 from 25-OH-D 3 -24-hydroxylase into -23-hydroxylase, generating 1α,25-(OH) 2 D 3 -26,23-lactone. Proceedings of the National Academy of Sciences. 2007;104(31):12673-12678. doi: https://doi.org/10.1073/pnas.0702093104Prosser DE, Kaufmann M, O’Leary B, Byford V, Jones G. Single A326G mutation converts human CYP24A1 from 25-OH-D 3 -24-hydroxylase into -23-hydroxylase, generating 1α,25-(OH) 2 D 3 -26,23-lactone. Proceedings of the National Academy of Sciences. 2007;104(31):12673-12678. doi: https://doi.org/10.1073/pnas.0702093104Cappellani D, Brancatella A, Kaufmann M, et al. Hereditary Hypercalcemia Caused by a Homozygous Pathogenic Variant in the CYP24A1 Gene: A Case Report and Review of the Literature. Case Rep Endocrinol. 2019;2019:1-7. doi: https://doi.org/10.1155/2019/4982621Cappellani D, Brancatella A, Kaufmann M, et al. Hereditary Hypercalcemia Caused by a Homozygous Pathogenic Variant in the CYP24A1 Gene: A Case Report and Review of the Literature. Case Rep Endocrinol. 2019;2019:1-7. doi: https://doi.org/10.1155/2019/4982621Jones G, Kaufmann M. Diagnostic Aspects of Vitamin D: Clinical Utility of Vitamin D Metabolite Profiling. JBMR Plus. 2021;5(12). doi: https://doi.org/10.1002/jbm4.10581Jones G, Kaufmann M. Diagnostic Aspects of Vitamin D: Clinical Utility of Vitamin D Metabolite Profiling. JBMR Plus. 2021;5(12). doi: https://doi.org/10.1002/jbm4.10581Molnár F, Sigüeiro R, Sato Y, et al. 1α,25(OH)2-3-Epi-Vitamin D3, a Natural Physiological Metabolite of Vitamin D3: Its Synthesis, Biological Activity and Crystal Structure with Its Receptor. PLoS One. 2011;6(3):e18124. doi: https://doi.org/10.1371/journal.pone.0018124Molnár F, Sigüeiro R, Sato Y, et al. 1α,25(OH)2-3-Epi-Vitamin D3, a Natural Physiological Metabolite of Vitamin D3: Its Synthesis, Biological Activity and Crystal Structure with Its Receptor. PLoS One. 2011;6(3):e18124. doi: https://doi.org/10.1371/journal.pone.0018124Kamao M, Tatematsu S, Hatakeyama S, et al. C-3 Epimerization of Vitamin D3 Metabolites and Further Metabolism of C-3 Epimers. Journal of Biological Chemistry. 2004;279(16):15897-15907. doi: https://doi.org/10.1074/jbc.M311473200Kamao M, Tatematsu S, Hatakeyama S, et al. C-3 Epimerization of Vitamin D3 Metabolites and Further Metabolism of C-3 Epimers. Journal of Biological Chemistry. 2004;279(16):15897-15907. doi: https://doi.org/10.1074/jbc.M311473200Astecker N, Satyanarayana Reddy G, Herzig G, Vorisek G, Schuster I. 1α,25-Dihydroxy-3-epi-vitamin D3 a physiological metabolite of 1α,25-dihydroxyvitamin D3: Its production and metabolism in primary human keratinocytes. Mol Cell Endocrinol. 2000;170(1-2):91-101. doi: https://doi.org/10.1016/S0303-7207(00)00330-0Astecker N, Satyanarayana Reddy G, Herzig G, Vorisek G, Schuster I. 1α,25-Dihydroxy-3-epi-vitamin D3 a physiological metabolite of 1α,25-dihydroxyvitamin D3: Its production and metabolism in primary human keratinocytes. Mol Cell Endocrinol. 2000;170(1-2):91-101. doi: https://doi.org/10.1016/S0303-7207(00)00330-0Singh RJ, Taylor RL, Reddy GS, Grebe SKG. C-3 Epimers Can Account for a Significant Proportion of Total Circulating 25-Hydroxyvitamin D in Infants, Complicating Accurate Measurement and Interpretation of Vitamin D Status. J Clin Endocrinol Metab. 2006;91(8):3055-3061. doi: https://doi.org/10.1210/jc.2006-0710Singh RJ, Taylor RL, Reddy GS, Grebe SKG. C-3 Epimers Can Account for a Significant Proportion of Total Circulating 25-Hydroxyvitamin D in Infants, Complicating Accurate Measurement and Interpretation of Vitamin D Status. J Clin Endocrinol Metab. 2006;91(8):3055-3061. doi: https://doi.org/10.1210/jc.2006-0710Granado-Lorencio F, Blanco-Navarro I, Pérez-Sacristán B, Donoso-Navarro E, Silvestre-Mardomingo R. Serum levels of 3-Epi-25-OH-D3 during Hypervitaminosis D in Clinical Practice. J Clin Endocrinol Metab. 2012;97(12):E2266-E2270. doi: https://doi.org/10.1210/jc.2012-2627Granado-Lorencio F, Blanco-Navarro I, Pérez-Sacristán B, Donoso-Navarro E, Silvestre-Mardomingo R. Serum levels of 3-Epi-25-OH-D3 during Hypervitaminosis D in Clinical Practice. J Clin Endocrinol Metab. 2012;97(12):E2266-E2270. doi: https://doi.org/10.1210/jc.2012-2627Zerwekh JE. Blood biomarkers of vitamin D status. Am J Clin Nutr. 2008;87(4):1087S-1091S. doi: https://doi.org/10.1093/ajcn/87.4.1087SZerwekh JE. Blood biomarkers of vitamin D status. Am J Clin Nutr. 2008;87(4):1087S-1091S. doi: https://doi.org/10.1093/ajcn/87.4.1087SSaponaro F, Saba A, Zucchi R. An Update on Vitamin D Metabolism. Int J Mol Sci. 2020;21(18):6573. doi: https://doi.org/10.3390/ijms21186573Saponaro F, Saba A, Zucchi R. An Update on Vitamin D Metabolism. Int J Mol Sci. 2020;21(18):6573. doi: https://doi.org/10.3390/ijms21186573Saponaro F, Saba A, Zucchi R. An Update on Vitamin D Metabolism. Int J Mol Sci. 2020;21(18):6573. doi: https://doi.org/10.3390/ijms21186573Saponaro F, Saba A, Zucchi R. An Update on Vitamin D Metabolism. Int J Mol Sci. 2020;21(18):6573. doi: https://doi.org/10.3390/ijms21186573Chun RF, Peercy BE, Orwoll ES, Nielson CM, Adams JS, Hewison M. Vitamin D and DBP: The free hormone hypothesis revisited. J Steroid Biochem Mol Biol. 2014;144:132-137. doi: https://doi.org/10.1016/j.jsbmb.2013.09.012Chun RF, Peercy BE, Orwoll ES, Nielson CM, Adams JS, Hewison M. Vitamin D and DBP: The free hormone hypothesis revisited. J Steroid Biochem Mol Biol. 2014;144:132-137. doi: https://doi.org/10.1016/j.jsbmb.2013.09.012Abboud M, Puglisi DA, Davies BN, et al. Evidence for a Specific Uptake and Retention Mechanism for 25-Hydroxyvitamin D (25OHD) in Skeletal Muscle Cells. Endocrinology. 2013;154(9):3022-3030. doi: https://doi.org/10.1210/en.2012-2245Abboud M, Puglisi DA, Davies BN, et al. Evidence for a Specific Uptake and Retention Mechanism for 25-Hydroxyvitamin D (25OHD) in Skeletal Muscle Cells. Endocrinology. 2013;154(9):3022-3030. doi: https://doi.org/10.1210/en.2012-2245Hernando N, Pastor‐Arroyo EM, Marks J, et al. 1,25(OH) 2 vitamin D 3 stimulates active phosphate transport but not paracellular phosphate absorption in mouse intestine. J Physiol. 2021;599(4):1131-1150. doi: https://doi.org/10.1113/JP280345Hernando N, Pastor‐Arroyo EM, Marks J, et al. 1,25(OH) 2 vitamin D 3 stimulates active phosphate transport but not paracellular phosphate absorption in mouse intestine. J Physiol. 2021;599(4):1131-1150. doi: https://doi.org/10.1113/JP280345Saito H, Maeda A, Ohtomo S ichi, et al. Circulating FGF-23 Is Regulated by 1α,25-Dihydroxyvitamin D3 and Phosphorus in Vivo. Journal of Biological Chemistry. 2005;280(4):2543-2549. doi: https://doi.org/10.1074/jbc.M408903200Saito H, Maeda A, Ohtomo S ichi, et al. Circulating FGF-23 Is Regulated by 1α,25-Dihydroxyvitamin D3 and Phosphorus in Vivo. Journal of Biological Chemistry. 2005;280(4):2543-2549. doi: https://doi.org/10.1074/jbc.M408903200Verlinden L, Carmeliet G. Integrated View on the Role of Vitamin D Actions on Bone and Growth Plate Homeostasis. JBMR Plus. 2021;5(12). doi: https://doi.org/10.1002/jbm4.10577Verlinden L, Carmeliet G. Integrated View on the Role of Vitamin D Actions on Bone and Growth Plate Homeostasis. JBMR Plus. 2021;5(12). doi: https://doi.org/10.1002/jbm4.10577Nemere I, Dormanen MC, Hammond MW, Okamura WH, Norman AW. Identification of a specific binding protein for 1 alpha,25-dihydroxyvitamin D3 in basal-lateral membranes of chick intestinal epithelium and relationship to transcaltachia. Journal of Biological Chemistry. 1994;269(38):23750-23756. doi: https://doi.org/10.1016/S0021-9258(17)31579-XNemere I, Dormanen MC, Hammond MW, Okamura WH, Norman AW. Identification of a specific binding protein for 1 alpha,25-dihydroxyvitamin D3 in basal-lateral membranes of chick intestinal epithelium and relationship to transcaltachia. Journal of Biological Chemistry. 1994;269(38):23750-23756. doi: https://doi.org/10.1016/S0021-9258(17)31579-XBuitrago C, Pardo VG, Boland R. Role of VDR in 1α,25-dihydroxyvitamin D3-dependent non-genomic activation of MAPKs, Src and Akt in skeletal muscle cells. J Steroid Biochem Mol Biol. 2013;136:125-130. doi: https://doi.org/10.1016/j.jsbmb.2013.02.013Buitrago C, Pardo VG, Boland R. Role of VDR in 1α,25-dihydroxyvitamin D3-dependent non-genomic activation of MAPKs, Src and Akt in skeletal muscle cells. J Steroid Biochem Mol Biol. 2013;136:125-130. doi: https://doi.org/10.1016/j.jsbmb.2013.02.013Vassalotti JA, Uribarri J, Chen SC, et al. Trends in Mineral Metabolism: Kidney Early Evaluation Program (KEEP) and the National Health and Nutrition Examination Survey (NHANES) 1999-2004. American Journal of Kidney Diseases. 2008;51(4):S56-S68. doi: https://doi.org/10.1053/j.ajkd.2007.12.018Vassalotti JA, Uribarri J, Chen SC, et al. Trends in Mineral Metabolism: Kidney Early Evaluation Program (KEEP) and the National Health and Nutrition Examination Survey (NHANES) 1999-2004. American Journal of Kidney Diseases. 2008;51(4):S56-S68. doi: https://doi.org/10.1053/j.ajkd.2007.12.018Moranne O, Froissart M, Rossert J, et al. Timing of Onset of CKD-Related Metabolic Complications. Journal of the American Society of Nephrology. 2009;20(1):164-171. doi: https://doi.org/10.1681/ASN.2008020159Moranne O, Froissart M, Rossert J, et al. Timing of Onset of CKD-Related Metabolic Complications. Journal of the American Society of Nephrology. 2009;20(1):164-171. doi: https://doi.org/10.1681/ASN.2008020159Hu MC, Kuro-o M, Moe OW. The emerging role of Klotho in clinical nephrology. Nephrology Dialysis Transplantation. 2012;27(7):2650-2657. doi: https://doi.org/10.1093/ndt/gfs160Hu MC, Kuro-o M, Moe OW. The emerging role of Klotho in clinical nephrology. Nephrology Dialysis Transplantation. 2012;27(7):2650-2657. doi: https://doi.org/10.1093/ndt/gfs160Dusso A, González EA, Martin KJ. Vitamin D in chronic kidney disease. Best Pract Res Clin Endocrinol Metab. 2011;25(4):647-655. doi: https://doi.org/10.1016/j.beem.2011.05.005Dusso A, González EA, Martin KJ. Vitamin D in chronic kidney disease. Best Pract Res Clin Endocrinol Metab. 2011;25(4):647-655. doi: https://doi.org/10.1016/j.beem.2011.05.005Isakova T, Wahl P, Vargas GS, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011;79(12):1370-1378. doi: https://doi.org/10.1038/ki.2011.47Isakova T, Wahl P, Vargas GS, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011;79(12):1370-1378. doi: https://doi.org/10.1038/ki.2011.47Dusso AS, Tokumoto M. Defective renal maintenance of the vitamin D endocrine system impairs vitamin D renoprotection: a downward spiral in kidney disease. Kidney Int. 2011;79(7):715-729. doi: https://doi.org/10.1038/ki.2010.543Dusso AS, Tokumoto M. Defective renal maintenance of the vitamin D endocrine system impairs vitamin D renoprotection: a downward spiral in kidney disease. Kidney Int. 2011;79(7):715-729. doi: https://doi.org/10.1038/ki.2010.543Mehrotra R, Kermah D, Budoff M, et al. Hypovitaminosis D in Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology. 2008;3(4):1144-1151. doi: https://doi.org/10.2215/CJN.05781207Mehrotra R, Kermah D, Budoff M, et al. Hypovitaminosis D in Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology. 2008;3(4):1144-1151. doi: https://doi.org/10.2215/CJN.05781207Michaud J, Naud J, Ouimet D, et al. Reduced Hepatic Synthesis of Calcidiol in Uremia. Journal of the American Society of Nephrology. 2010;21(9):1488-1497. doi: https://doi.org/10.1681/ASN.2009080815Michaud J, Naud J, Ouimet D, et al. Reduced Hepatic Synthesis of Calcidiol in Uremia. Journal of the American Society of Nephrology. 2010;21(9):1488-1497. doi: https://doi.org/10.1681/ASN.2009080815Hsu CH, Patel S. Uremic plasma contains factors inhibiting 1 alphahydroxylase activity. Journal of the American Society of Nephrology. 1992;3(4):947-952. doi: https://doi.org/10.1681/ASN.V34947Hsu CH, Patel S. Uremic plasma contains factors inhibiting 1 alphahydroxylase activity. Journal of the American Society of Nephrology. 1992;3(4):947-952. doi: https://doi.org/10.1681/ASN.V34947Bachmann S, Schlichting U, Geist B, et al. Kidney-Specific Inactivation of the Megalin Gene Impairs Trafficking of Renal Inorganic Sodium Phosphate Cotransporter (NaPi-IIa). Journal of the American Society of Nephrology. 2004;15(4):892-900. doi: https://doi.org/10.1097/01.ASN.0000120389.09938.21Bachmann S, Schlichting U, Geist B, et al. Kidney-Specific Inactivation of the Megalin Gene Impairs Trafficking of Renal Inorganic Sodium Phosphate Cotransporter (NaPi-IIa). Journal of the American Society of Nephrology. 2004;15(4):892-900. doi: https://doi.org/10.1097/01.ASN.0000120389.09938.21Hyder R, Sprague SM. Secondary Hyperparathyroidism in a Patient with CKD. Clinical Journal of the American Society of Nephrology. 2020;15(7):1041-1043. doi: https://doi.org/10.2215/CJN.13411119Hyder R, Sprague SM. Secondary Hyperparathyroidism in a Patient with CKD. Clinical Journal of the American Society of Nephrology. 2020;15(7):1041-1043. doi: https://doi.org/10.2215/CJN.13411119Galitzer H, Ben-Dov IZ, Silver J, Naveh-Many T. Parathyroid cell resistance to fibroblast growth factor 23 in secondary hyperparathyroidism of chronic kidney disease. Kidney Int. 2010;77(3):211-218. doi: https://doi.org/10.1038/ki.2009.464Galitzer H, Ben-Dov IZ, Silver J, Naveh-Many T. Parathyroid cell resistance to fibroblast growth factor 23 in secondary hyperparathyroidism of chronic kidney disease. Kidney Int. 2010;77(3):211-218. doi: https://doi.org/10.1038/ki.2009.464Jørgensen HS, de Loor H, Billen J, et al. Vitamin D Metabolites Before and After Kidney Transplantation in Patients Who Are Anephric. American Journal of Kidney Diseases. 2024;84(4):427-436.e1. doi: https://doi.org/10.1053/j.ajkd.2024.03.025Jørgensen HS, de Loor H, Billen J, et al. Vitamin D Metabolites Before and After Kidney Transplantation in Patients Who Are Anephric. American Journal of Kidney Diseases. 2024;84(4):427-436.e1. doi: https://doi.org/10.1053/j.ajkd.2024.03.025Dai B, David V, Alshayeb HM, et al. Assessment of 24,25(OH)2D levels does not support FGF23-mediated catabolism of vitamin D metabolites. Kidney Int. 2012;82(10):1061-1070. doi: https://doi.org/10.1038/ki.2012.222Dai B, David V, Alshayeb HM, et al. Assessment of 24,25(OH)2D levels does not support FGF23-mediated catabolism of vitamin D metabolites. Kidney Int. 2012;82(10):1061-1070. doi: https://doi.org/10.1038/ki.2012.222de Boer IH, Sachs MC, Chonchol M, et al. Estimated GFR and Circulating 24,25-Dihydroxyvitamin D3 Concentration: A Participant-Level Analysis of 5 Cohort Studies and Clinical Trials. American Journal of Kidney Diseases. 2014;64(2):187-197. doi: https://doi.org/10.1053/j.ajkd.2014.02.015de Boer IH, Sachs MC, Chonchol M, et al. Estimated GFR and Circulating 24,25-Dihydroxyvitamin D3 Concentration: A Participant-Level Analysis of 5 Cohort Studies and Clinical Trials. American Journal of Kidney Diseases. 2014;64(2):187-197. doi: https://doi.org/10.1053/j.ajkd.2014.02.015Hsu S, Zelnick LR, Lin YS, et al. Validation of the 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 ratio as a biomarker of 25-hydroxyvitamin D3 clearance. J Steroid Biochem Mol Biol. 2022;217:106047. doi: https://doi.org/10.1016/j.jsbmb.2021.106047Hsu S, Zelnick LR, Lin YS, et al. Validation of the 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 ratio as a biomarker of 25-hydroxyvitamin D3 clearance. J Steroid Biochem Mol Biol. 2022;217:106047. doi: https://doi.org/10.1016/j.jsbmb.2021.106047Turner ME, Rowsell TS, White CA, et al. The metabolism of 1,25(OH)2D3 in clinical and experimental kidney disease. Sci Rep. 2022;12(1):10925. doi: https://doi.org/10.1038/s41598-022-15033-9Turner ME, Rowsell TS, White CA, et al. The metabolism of 1,25(OH)2D3 in clinical and experimental kidney disease. Sci Rep. 2022;12(1):10925. doi: https://doi.org/10.1038/s41598-022-15033-9https://kdigo.org/wp-content/uploads/2017/02/KDIGO-2009-CKDMBD-Guideline-English.pdfhttps://kdigo.org/wp-content/uploads/2017/02/KDIGO-2009-CKDMBD-Guideline-English.pdfJayedi A, Soltani S, Shab-Bidar S. Vitamin D Status and All-Cause Mortality in Patients With Chronic Kidney Disease: A Systematic Review and Dose-Response Meta-Analysis. J Clin Endocrinol Metab. 2017;102(7):2136-2145. doi: https://doi.org/10.1210/jc.2017-00105Jayedi A, Soltani S, Shab-Bidar S. Vitamin D Status and All-Cause Mortality in Patients With Chronic Kidney Disease: A Systematic Review and Dose-Response Meta-Analysis. J Clin Endocrinol Metab. 2017;102(7):2136-2145. doi: https://doi.org/10.1210/jc.2017-00105Yeung WCG, Palmer SC, Strippoli GFM, et al. Vitamin D Therapy in Adults With CKD: A Systematic Review and Meta-analysis. American Journal of Kidney Diseases. 2023;82(5):543-558. doi: https://doi.org/10.1053/j.ajkd.2023.04.003Yeung WCG, Palmer SC, Strippoli GFM, et al. Vitamin D Therapy in Adults With CKD: A Systematic Review and Meta-analysis. American Journal of Kidney Diseases. 2023;82(5):543-558. doi: https://doi.org/10.1053/j.ajkd.2023.04.003Российская ассоциация эндокринологов. Дефицит витамина D: клинические рекомендации. 2021. URL: https://rae-org.ru/system/files/documents/pdf/d_2021.pdf (дата обращения: 10.02.2025).Rossijskaya associaciya endokrinologov. Deficit vitamina D: klinicheskie rekomendacii. 2021. (In Russ.).Ennis JL, Worcester EM, Coe FL, Sprague SM. Current recommended 25-hydroxyvitamin D targets for chronic kidney disease management may be too low. J Nephrol. 2016;29(1):63-70. doi: https://doi.org/10.1007/s40620-015-0186-0Ennis JL, Worcester EM, Coe FL, Sprague SM. Current recommended 25-hydroxyvitamin D targets for chronic kidney disease management may be too low. J Nephrol. 2016;29(1):63-70. doi: https://doi.org/10.1007/s40620-015-0186-0Bikle D, Bouillon R, Thadhani R, Schoenmakers I. Vitamin D metabolites in captivity? Should we measure free or total 25(OH)D to assess vitamin D status? J Steroid Biochem Mol Biol. 2017;173:105-116. doi: https://doi.org/10.1016/j.jsbmb.2017.01.007Bikle D, Bouillon R, Thadhani R, Schoenmakers I. Vitamin D metabolites in captivity? Should we measure free or total 25(OH)D to assess vitamin D status? J Steroid Biochem Mol Biol. 2017;173:105-116. doi: https://doi.org/10.1016/j.jsbmb.2017.01.007Castillo-Peinado L de los S, Calderón-Santiago M, Herrera-Martínez AD, et al. Measuring Vitamin D3 Metabolic Status, Comparison between Vitamin D Deficient and Sufficient Individuals. Separations. 2022;9(6):141. doi: https://doi.org/10.3390/separations9060141Castillo-Peinado L de los S, Calderón-Santiago M, Herrera-Martínez AD, et al. Measuring Vitamin D3 Metabolic Status, Comparison between Vitamin D Deficient and Sufficient Individuals. Separations. 2022;9(6):141. doi: https://doi.org/10.3390/separations9060141Bosworth CR, Levin G, Robinson-Cohen C, et al. The serum 24,25-dihydroxyvitamin D concentration, a marker of vitamin D catabolism, is reduced in chronic kidney disease. Kidney Int. 2012;82(6):693-700. doi: https://doi.org/10.1038/ki.2012.193Bosworth CR, Levin G, Robinson-Cohen C, et al. The serum 24,25-dihydroxyvitamin D concentration, a marker of vitamin D catabolism, is reduced in chronic kidney disease. Kidney Int. 2012;82(6):693-700. doi: https://doi.org/10.1038/ki.2012.193Lee S, Chung HJ, Jung S, et al. 24,25-Dihydroxy Vitamin D and Vitamin D Metabolite Ratio as Biomarkers of Vitamin D in Chronic Kidney Disease. Nutrients. 2023;15(3):578. doi: https://doi.org/10.3390/nu15030578Lee S, Chung HJ, Jung S, et al. 24,25-Dihydroxy Vitamin D and Vitamin D Metabolite Ratio as Biomarkers of Vitamin D in Chronic Kidney Disease. Nutrients. 2023;15(3):578. doi: https://doi.org/10.3390/nu15030578Galassi A, Fasulo EM, Ciceri P, et al. 1,25-dihydroxyvitamin D as Predictor of Renal Worsening Function in Chronic Kidney Disease. Results From the PASCaL-1,25D Study. Front Med (Lausanne). 2022;9. doi: https://doi.org/10.3389/fmed.2022.840801Galassi A, Fasulo EM, Ciceri P, et al. 1,25-dihydroxyvitamin D as Predictor of Renal Worsening Function in Chronic Kidney Disease. Results From the PASCaL-1,25D Study. Front Med (Lausanne). 2022;9. doi: https://doi.org/10.3389/fmed.2022.840801Tentori F, Blayney MJ, Albert JM, et al. Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). American Journal of Kidney Diseases. 2008;52(3):519-530. doi: https://doi.org/10.1053/j.ajkd.2008.03.020Tentori F, Blayney MJ, Albert JM, et al. Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). American Journal of Kidney Diseases. 2008;52(3):519-530. doi: https://doi.org/10.1053/j.ajkd.2008.03.020Cozzolino M, Brancaccio D, Cannella G, et al. VDRA therapy is associated with improved survival in dialysis patients with serum intact PTH <=150 pg/mL: results of the Italian FARO Survey. Nephrology Dialysis Transplantation. 2012;27(9):3588-3594. doi: https://doi.org/10.1093/ndt/gfs108Cozzolino M, Brancaccio D, Cannella G, et al. VDRA therapy is associated with improved survival in dialysis patients with serum intact PTH <=150 pg/mL: results of the Italian FARO Survey. Nephrology Dialysis Transplantation. 2012;27(9):3588-3594. doi: https://doi.org/10.1093/ndt/gfs108Yu Y, Diao Z, Wang Y, Zhou P, Ding R, Liu W. Hemodialysis patients with low serum parathyroid hormone levels have a poorer prognosis than those with secondary hyperparathyroidism. Ther Adv Endocrinol Metab. 2020;11. doi: https://doi.org/10.1177/2042018820958322Yu Y, Diao Z, Wang Y, Zhou P, Ding R, Liu W. Hemodialysis patients with low serum parathyroid hormone levels have a poorer prognosis than those with secondary hyperparathyroidism. Ther Adv Endocrinol Metab. 2020;11. doi: https://doi.org/10.1177/2042018820958322Thadhani R, Appelbaum E, Pritchett Y, et al. Vitamin D Therapy and Cardiac Structure and Function in Patients With Chronic Kidney Disease. JAMA. 2012;307(7):674. doi: https://doi.org/10.1001/jama.2012.120Thadhani R, Appelbaum E, Pritchett Y, et al. Vitamin D Therapy and Cardiac Structure and Function in Patients With Chronic Kidney Disease. JAMA. 2012;307(7):674. doi: https://doi.org/10.1001/jama.2012.120Wang AYM, Fang F, Chan J, et al. Effect of Paricalcitol on Left Ventricular Mass and Function in CKD—The OPERA Trial. Journal of the American Society of Nephrology. 2014;25(1):175-186. doi: https://doi.org/10.1681/ASN.2013010103Wang AYM, Fang F, Chan J, et al. Effect of Paricalcitol on Left Ventricular Mass and Function in CKD—The OPERA Trial. Journal of the American Society of Nephrology. 2014;25(1):175-186. doi: https://doi.org/10.1681/ASN.2013010103Bellasi A, Mandreoli M, Baldrati L, et al. Chronic Kidney Disease Progression and Outcome According to Serum Phosphorus in Mild-to-Moderate Kidney Dysfunction. Clinical Journal of the American Society of Nephrology. 2011;6(4):883-891. doi: https://doi.org/10.2215/CJN.07810910Bellasi A, Mandreoli M, Baldrati L, et al. Chronic Kidney Disease Progression and Outcome According to Serum Phosphorus in Mild-to-Moderate Kidney Dysfunction. Clinical Journal of the American Society of Nephrology. 2011;6(4):883-891. doi: https://doi.org/10.2215/CJN.07810910Lopes MB, Karaboyas A, Bieber B, et al. Impact of longer term phosphorus control on cardiovascular mortality in hemodialysis patients using an area under the curve approach: results from the DOPPS. Nephrology Dialysis Transplantation. 2020;35(10):1794-1801. doi: https://doi.org/10.1093/ndt/gfaa054Lopes MB, Karaboyas A, Bieber B, et al. Impact of longer term phosphorus control on cardiovascular mortality in hemodialysis patients using an area under the curve approach: results from the DOPPS. Nephrology Dialysis Transplantation. 2020;35(10):1794-1801. doi: https://doi.org/10.1093/ndt/gfaa054Fan Z, Li R, Pan M, et al. Relationship between serum phosphorus and mortality in non-dialysis chronic kidney disease patients: evidence from NHANES 2001–2018. BMC Nephrol. 2024;25(1):89. doi: https://doi.org/10.1186/s12882-024-03525-xFan Z, Li R, Pan M, et al. Relationship between serum phosphorus and mortality in non-dialysis chronic kidney disease patients: evidence from NHANES 2001–2018. BMC Nephrol. 2024;25(1):89. doi: https://doi.org/10.1186/s12882-024-03525-xLim LM, Kuo HT, Kuo MC, et al. Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3–4 patients. BMC Nephrol. 2014;15(1):183. doi: https://doi.org/10.1186/1471-2369-15-183Lim LM, Kuo HT, Kuo MC, et al. Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3–4 patients. BMC Nephrol. 2014;15(1):183. doi: https://doi.org/10.1186/1471-2369-15-183Janmaat CJ, van Diepen M, Gasparini A, et al. Lower serum calcium is independently associated with CKD progression. Sci Rep. 2018;8(1):5148. doi: https://doi.org/10.1038/s41598-018-23500-5Janmaat CJ, van Diepen M, Gasparini A, et al. Lower serum calcium is independently associated with CKD progression. Sci Rep. 2018;8(1):5148. doi: https://doi.org/10.1038/s41598-018-23500-5Hiyamuta H, Yamada S, Taniguchi M, Nakano T, Tsuruya K, Kitazono T. Causes of death in patients undergoing maintenance hemodialysis in Japan: 10-year outcomes of the Q-Cohort Study. Clin Exp Nephrol. 2021;25(10):1121-1130. doi: https://doi.org/10.1007/s10157-021-02089-6Hiyamuta H, Yamada S, Taniguchi M, Nakano T, Tsuruya K, Kitazono T. Causes of death in patients undergoing maintenance hemodialysis in Japan: 10-year outcomes of the Q-Cohort Study. Clin Exp Nephrol. 2021;25(10):1121-1130. doi: https://doi.org/10.1007/s10157-021-02089-6Yamaguchi S, Hamano T, Doi Y, et al. Hidden Hypocalcemia as a Risk Factor for Cardiovascular Events and All-Cause Mortality among Patients Undergoing Incident Hemodialysis. Sci Rep. 2020;10(1):4418. doi: https://doi.org/10.1038/s41598-020-61459-4Yamaguchi S, Hamano T, Doi Y, et al. Hidden Hypocalcemia as a Risk Factor for Cardiovascular Events and All-Cause Mortality among Patients Undergoing Incident Hemodialysis. Sci Rep. 2020;10(1):4418. doi: https://doi.org/10.1038/s41598-020-61459-4Kim ED, Watt J, Tereshchenko LG, et al. Associations of serum and dialysate electrolytes with QT interval and prolongation in incident hemodialysis: the Predictors of Arrhythmic and Cardiovascular Risk in End-Stage Renal Disease (PACE) study. BMC Nephrol. 2019;20(1):133. doi: https://doi.org/10.1186/s12882-019-1282-5Kim ED, Watt J, Tereshchenko LG, et al. Associations of serum and dialysate electrolytes with QT interval and prolongation in incident hemodialysis: the Predictors of Arrhythmic and Cardiovascular Risk in End-Stage Renal Disease (PACE) study. BMC Nephrol. 2019;20(1):133. doi: https://doi.org/10.1186/s12882-019-1282-5Taniguchi M, Fukagawa M, Fujii N, et al. Serum Phosphate and Calcium Should Be Primarily and Consistently Controlled in Prevalent Hemodialysis Patients. Therapeutic Apheresis and Dialysis. 2013;17(2):221-228. doi: https://doi.org/10.1111/1744-9987.12030Taniguchi M, Fukagawa M, Fujii N, et al. Serum Phosphate and Calcium Should Be Primarily and Consistently Controlled in Prevalent Hemodialysis Patients. Therapeutic Apheresis and Dialysis. 2013;17(2):221-228. doi: https://doi.org/10.1111/1744-9987.12030Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral Metabolism, Mortality, and Morbidity in Maintenance Hemodialysis. Journal of the American Society of Nephrology. 2004;15(8):2208-2218. doi: https://doi.org/10.1097/01.ASN.0000133041.27682.A2Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral Metabolism, Mortality, and Morbidity in Maintenance Hemodialysis. Journal of the American Society of Nephrology. 2004;15(8):2208-2218. doi: https://doi.org/10.1097/01.ASN.0000133041.27682.A2Yamada S, Arase H, Tokumoto M, et al. Increased Risk of Infection-Related and All-Cause Death in Hypercalcemic Patients Receiving Hemodialysis: The Q-Cohort Study. Sci Rep. 2020;10(1):6327. doi: https://doi.org/10.1038/s41598-020-63334-8Yamada S, Arase H, Tokumoto M, et al. Increased Risk of Infection-Related and All-Cause Death in Hypercalcemic Patients Receiving Hemodialysis: The Q-Cohort Study. Sci Rep. 2020;10(1):6327. doi: https://doi.org/10.1038/s41598-020-63334-8Yamada S, Giachelli CM. Vascular calcification in CKD-MBD: Roles for phosphate, FGF23, and Klotho. Bone. 2017;100:87-93. doi: https://doi.org/10.1016/j.bone.2016.11.012Yamada S, Giachelli CM. Vascular calcification in CKD-MBD: Roles for phosphate, FGF23, and Klotho. Bone. 2017;100:87-93. doi: https://doi.org/10.1016/j.bone.2016.11.012Pasch A, Block GA, Bachtler M, et al. Blood Calcification Propensity, Cardiovascular Events, and Survival in Patients Receiving Hemodialysis in the EVOLVE Trial. Clinical Journal of the American Society of Nephrology. 2017;12(2):315-322. doi: https://doi.org/10.2215/CJN.04720416Pasch A, Block GA, Bachtler M, et al. Blood Calcification Propensity, Cardiovascular Events, and Survival in Patients Receiving Hemodialysis in the EVOLVE Trial. Clinical Journal of the American Society of Nephrology. 2017;12(2):315-322. doi: https://doi.org/10.2215/CJN.04720416Henderson RR, Santiago LM, Spring DA, Harrington AR. Metastatic Myocardial Calcification in Chronic Renal Failure Presenting as Atrioventricular Block. New England Journal of Medicine. 1971;284(22):1252-1253. doi: https://doi.org/10.1056/NEJM197106032842208Henderson RR, Santiago LM, Spring DA, Harrington AR. Metastatic Myocardial Calcification in Chronic Renal Failure Presenting as Atrioventricular Block. New England Journal of Medicine. 1971;284(22):1252-1253. doi: https://doi.org/10.1056/NEJM197106032842208

The authors declare that there are no conflicts of interest present.