Do you recommend using vitamin D analogs for patients with CKD and a high PTH but a normal 25-hydroxy vitamin D level?

The answer is that it depends on how high the PTH level is. KDIGO guidelines originally recommended targeting PTH between 65 and 130 for patients with non-dialysis CKD by using nutritional vitamin D if the 25-OH vitamin D level is low and using active vitamin D if the 25-OH vitamin D level is normal...

The real answer to the question is I don't know. However in the meantime, I do treat PTH over 100 in patients with ckd stage 3. First I would treat 25 vitamin D deficiency if present. If patient does not respond, then I would give 1,25 vitamin D (calcitriol) unless the serum calcium is elevated.

Yes, I do recommend using vitamin D analogs such as calcitriol e.g. starting at 0.25 mcg every other day for patients with CKD not on dialysis and a high PTH (>70 pg/ml) or on dialysis (>130 pg/ml) even if there is normal 25-hydroxy vitamin D level (>30) or even of patient is on adequate doses of D3...