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Vitamin D deficiency (serum total 25-OH vitamin D levels\u00a0&lt; 30\u00a0ng\/mL) occurs early in the course of chronic kidney disease and treatment guidelines recommend early intervention to restore 25-OH vitamin D levels as a first step to prevent\/delay the onset\/progression of secondary hyperparathyroidism. The vitamin D forms administered to replace 25-OH vitamin D include cholecalciferol, ergocalciferol, and immediate- or extended-release formulations of calcifediol. Most patients with intermediate-stage chronic kidney disease will develop secondary hyperparathyroidism before dialysis is required. Control of parathyroid hormone levels becomes a major focus of therapy in these patients. This article focuses on the position of extended-release calcifediol in the treatment of patients with stage 3\u20134 chronic kidney disease and secondary hyperparathyroidism with hypovitaminosis D. Several characteristics of extended-release calcifediol support its use in the intermediate stages of chronic kidney disease. The pharmacokinetics of extended-release calcifediol make it effective for replenishing 25-OH vitamin D levels, with minimal impact on vitamin D catabolism from fibroblast-growth factor-23 and CYP24A1 upregulation. Extended-release calcifediol increases circulating 25-OH vitamin D levels in a dose-dependent manner and lowers parathyroid hormone levels by a clinically relevant extent, comparable to what can be achieved by administering active vitamin D analogues, though with a lower risk of hypercalcaemia and hyperphosphataemia. Active vitamin D analogues are reserved for patients undergoing dialysis or pre-dialysis patients with severe progressive secondary hyperparathyroidism.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphic abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s40620-021-01152-5","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T12:10:28Z","timestamp":1633867828000},"page":"863-873","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Extended-release calcifediol in stage 3\u20134 chronic kidney disease: a new therapy for the treatment of secondary hyperparathyroidism associated with hypovitaminosis D"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-6252","authenticated-orcid":false,"given":"Mario","family":"Cozzolino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Minghetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Navarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,9]]},"reference":[{"key":"1152_CR1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0158765","volume":"11","author":"NR Hill","year":"2016","unstructured":"Hill NR, Fatoba ST, Oke JL et al (2016) Global prevalence of chronic kidney disease\u2014a systematic review and meta-analysis. 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PM declares no competing interest. PN has attended a board meeting supported by Vifor Pharma.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants performed by any of the authors","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}