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Brand names: Zemplar • Drug class: Active vitamin D analog
Paricalcitol is an active vitamin D analog used in CKD-MBD to control secondary hyperparathyroidism — it suppresses PTH with less calcium and phosphorus rise than calcitriol. For dialysis patients with uncontrolled PTH, it's a standard part of bone-mineral management.
As CKD progresses, the kidney loses 1-alpha-hydroxylase activity — active vitamin D falls and PTH rises. Paricalcitol replaces active vitamin D, lowering PTH while monitoring calcium and phosphorus. It's used in CKD stages 3-5 and dialysis, dosed by baseline PTH; the main monitoring targets: calcium, phosphorus, and PTH levels (KDIGO: avoid over-suppression).
Paricalcitol suppresses PTH with less hypercalcemia/phosphate rise than calcitriol in comparative studies
CKD-MBD literature, 2023
KDIGO 2017: use vitamin D analogs in CKD-MBD with careful calcium/phosphorus monitoring
KDIGO CKD-MBD guideline, 2017
Dosed by PTH level and CKD stage, not by eGFR per se. Oral: 1-4 mcg/day or 2-3×/week titrated to PTH. IV (dialysis): 2.5-10 mcg 3×/week. Monitor calcium and phosphorus at least monthly when titrating; hold for hypercalcemia.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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