[The application of vitamin D and its analogues in patients with chronic kidney disease: the Chinese practice program (2019)].

Vitamin D insufficiency/deficiency are common in the general population and in patients with chronic kidney disease (CKD), and should be avoided by using supplementation.Although many domestic and foreign clinical practice guidelines or expert consensus have made norms for the reasonable application of vitamin D and its analogues, most of them are limited to a certain disease or complication, and there is still a lack of overall guidance for CKD patients. In addition, the previous clinical practice guidelines have insufficient description of the pharmacological effects of vitamin D and its analogues and insufficient guidance on how to rationally choose them for individualized treatment based on the different pathophysiology of CKD. Aiming at common problems in the diagnosis and treatment of CKD, this present practice systematically introduces vitamin D and its analogues on the following aspects: sources and metabolism, classification, pharmacology, indications, monitoring and management, clinical usage, adverse reactions and precautions. This Chinese practice is intended to standardize the use of vitamin D and its analogues in CKD patients and improve the clinical diagnosis and treatment of CKD. With more evidence from relevant research worldwide, this Chinese practice will be revised in the future.维生素D及其类似物的不足/缺乏在我国普通人群和慢性肾脏病（CKD）患者中广泛存在，维生素D及其类似物亦广泛应用于CKD患者治疗。尽管多个国内外临床实践指南或专家共识对维生素D及其类似物合理应用做出了规范，但多为针对某一疾病或并发症，缺乏针对CKD患者维生素D及其类似物的整体指导建议。并且，基于循证医学证据的临床实践指南中，对维生素D及其类似物的药理作用阐述不足，对如何依据CKD患者不同病理生理状态合理选择维生素D及其类似物进行个体化治疗的指导不足。因此，本方案针对CKD诊疗实践中的常见问题，系统介绍了维生素D及其类似物的来源、代谢与分类、药理机制、适应范围、临床检测与管理目标、不同病理生理状态下临床用药选择和治疗方案以及不良反应与注意事项。旨在指导临床医生在CKD诊疗过程中，合理应用维生素D及其类似物，提高临床诊疗水平。并且，随着更多国内外相关研究证据的呈现，本方案将在未来重新修订。.