With late stage CKD (eGFR < 15 mL/min/1.73 m2), uremia can cause progressive loss of tissue VDR (clearly demonstrated in the parathyroids of uremic patients [45]) and diminishing binding capacity between 1,25(OH)2D and VDR, leading to tissue vitamin D resistance [46,47,48]. This evidence concerns the gene VDR and uremia.