23rd May 2025

A 60-year-old female with a background of chronic kidney disease stage 4 presents with symptoms of perioral numbness and muscle cramps.

A 60-year-old female with a background of chronic kidney disease stage 4 presents with symptoms of perioral numbness and muscle cramps. A set of blood tests show: eGFR 29 mL/min. Serum adjusted calcium levels of 1.70mmol/L. Her Vitamin D levels are 28 nanograms/mL (low). Intact PTH levels are 90 nanograms/L (raised). Phosphate levels are 1.5 mmol/L (raised).

How best would you manage the above patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.