Which hormone is typically elevated in CKD-related bone-mineral disorder?

• A. Calcitonin
• B. Erythropoietin
• C. Parathyroid hormone
• D. Aldosterone

Answer: (C)

In CKD-related bone-mineral disorder, the player is the parathyroid hormone. Kidney disease causes phosphate to accumulate and reduces the activation of vitamin D (calcitriol). The higher phosphate and lower calcitriol lower serum calcium, which triggers the parathyroid glands to release more PTH in an attempt to restore calcium balance. This ongoing rise in PTH is called secondary hyperparathyroidism and is a hallmark of CKD-MBD, driving bone turnover and mineral changes.

Calcitonin is not typically elevated in this condition, erythropoietin levels are usually low because the kidney isn’t producing enough of it, and aldosterone changes aren’t the defining feature of CKD-related bone-mineral disorders. Hence, parathyroid hormone is the hormone most characteristically elevated.