Q:

In chronic renal failure, main cause of Vit D deficiency is the failure of:

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In chronic renal failure, main cause of Vit D deficiency is the failure of: 


  1. Vit D absorption in intestines
  2. 25 alpha hydroxylation of Vit D
  3. Excess Vit D loss in urine
  4. 1 alpha hydroxylation of Vit D
  5. Availability of Vit D precursors

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The key is D. 1 alpha hydroxylation of Vit D. [There are 3 steps in the synthesis of vitamin D. i) Cholecalciferol in the skin from 7-dehydrocholesterol under the action of ultraviolet light. ii) Hydroxylation in the liver of cholecalciferol to 25-hydroxycholecalciferol. iii) Hydroxylation in the kidneys (1 alpha hydroxylation by enzyme 1-alphahydroxylase) of 25-hydroxycholecalciferol to calcitriol (1,25dihydroxyvitamin D3)]. 

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