慢性肾脏病(chronic kidney disease，CKD)患者在病程中逐渐出现活性维生素D 缺乏，红细胞生成素分泌减少，导致继发性甲状旁腺功能亢进以及肾性贫血。贫血及继发性甲状旁腺功能亢进的管理与CKD 患者的预后息息相关。不论是对社区人群、CKD 患者还是透析患者，目前临床研究均观察到维生素D 在红细胞生成方面的积极作用，从而改善贫血。维生素D 与贫血的联系部分依赖全段甲状旁腺素(intact parathyroid hormone，iPTH)。除此之外，非甲状旁腺素依赖的炎性反应、铁调素等也起到重要作用，其均有维生素D 受体(vitamin D receptor,VDR)激活这一共同途径。本文旨在探讨维生素D 与贫血的相互作用以及维生素D 缺乏与贫血相关性的可能机制，并从改善贫血的角度为CKD 患者，包括透析患者补充维生素D提供一些参考。

Patients of chronic kidney disease usually suffer from anemia and hyperparathyroidism secondary to deficiency of EPO and vitamin D as CKD progresses. The outcome of CKD is significantly influenced by the management of anemia and secondary hyperparathyroidism. Recently the association of vitamin D and anemia has been found in many researches no matter the population, the CKD patients and the patients on dialysis, but the mechanism is undefined. The relevance of vitamin D deficiency and anemia is partially dependent on parathyroid hormone (PTH). Besides, hepcidin and inflammation independent of PTH also play a significant role. The above possible aspects contribute to anemia via a common VDR pathway. This review focuses on current situation and probable mechanism of the interplay between vitamin D and anemia in order to provide a suggestion that administration of vitamin D or its analogues may improve the anemia state in CKD patients.