A pragmatic approach is warranted: replete deficiency with nutritional vitamin D (prefer D3; consider calcifediol when faster repletion or persistent SHPT is relevant), avoid mega-bolus dosing, and reserve active VDRAs for clear SHPT indications with careful calcium–phosphate–parathyroid hormone (PTH) monitoring—rather than positioning vitamin D as disease-modifying therapy for unselected CKD. Here, PTH is linked to chronic kidney disease.