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. 2013 Apr 8;23(2):134–162. doi: 10.1111/vec.12036

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Copyright © 2013 Veterinary Emergency and Critical Care Society

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Different stages of CKD in which calcitriol treatment can be considered

A = No calcitriol supplementation. Calcitriol normalizes only at the expense of elevated PTH.

B = Calcitriol treatment is started at time “x” late enough in the renal disease when calcitriol is decreased and PTH is elevated with restoration of both to normal.

C = Calcitriol treatment is started at an early enough stage where calcitriol concentrations are still normal as a consequence of the increased PTH. Calcitriol supplementation remains beneficial to maintain normal calcitriol concentrations while decreasing PTH.

D = Calcitriol treatment is started very early in the course of progressive nephron loss, prior to either PTH increase or calcitriol decrease as a preventative step.