Which treatment is recommended for low calcium levels in CKD patients?

In patients with chronic kidney disease (CKD), low calcium levels, known as hypocalcemia, can occur due to impaired renal function, which affects calcium metabolism and vitamin D activation. Calcitriol, the active form of vitamin D, is particularly important because it aids in the absorption of calcium from the diet and helps to regulate calcium levels in the blood.

Calcitriol is recommended for treating low calcium levels in CKD patients because it directly addresses the underlying issue of diminished vitamin D activation, which results in poor calcium absorption. By supplementing with calcitriol, these patients can enhance their intestinal absorption of calcium and increase serum calcium levels. Furthermore, calcitriol also helps in maintaining bone health by preventing secondary hyperparathyroidism that is common in CKD due to low calcium levels.

The other choices do not directly correct low calcium levels. Calcium carbonate, while it is a calcium supplement, is primarily used to bind phosphate in the gastrointestinal tract in CKD patients rather than effectively addressing hypocalcemia in isolation. Etidronate and alendronate are bisphosphonates used primarily in the treatment of osteoporosis and do not directly influence calcium levels in the context of CKD.