Vitamin d and chronic kidney disease davita vitamin d is necessary for good healthyet people with chronic kidney disease ckd and those who have end stage renal disease esrd and are on dialysis may not be getting enough vitamin d is activated in the kidneys so those with kidney failure may need medicines to get their dose of vitamin d. Chronic kidney disease ckd has been recognized as a significant global health problem because of the increased risk of total and cardiovascular morbidity and mortality vitamin d deficiency or insufficiency is common in patients with ckd and serum levels of vitamin d appear to have an inverse correlation with kidney function growing evidence has indicated that vitamin d deficiency may contribute to deteriorating renal function as well as increased morbidity and mortality in patients . Hyperparathyroidism occurs in most patients during the progression of chronic kidney disease ckd and one of its initiating events reduced serum levels of 125 dihydroxyvitamin d results from a decrease in renal 1 hydroxylase activity which converts 25 hydroxyvitamin d to its activated form the combination of persistently high parathyroid hormone pth and low 125 dihydroxyvitamin d is associated with bone loss cardiovascular disease immune suppression and increased mortality in . This book will focus on vitamin d in chronic kidney disease states discusses recent insights on vitamin d metabolism as well as its association with a diversity of non skeletal complications among them cardiovascular disease diabetes mellitus multiple sclerosis cancer tuberculosis and immune system dysfunction new players in the regulation of vitamin synthesis and degradation have been