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Vitamin D analogs are commonly used in patients with chronic kidney disease (CKD) to treat secondary hyperparathyroidism, which is an over production of parathyroid hormone caused by the inability of the kidneys to properly regulate calcium and phosphorus levels in the blood. This condition can lead to bone disease, and vitamin D analogs help to lower parathyroid hormone levels and improve bone health. Metabolic acidosis is not a common indication for vitamin D analogs in CKD, as it is typically managed with bicarbonate therapy. Similarly, anemia in CKD is primarily managed with erythropoietin stimulating agents (ESAs) and iron therapy, rather than vitamin D analogs. Hypertension may also be present in patients with CKD, but it is not a direct indication for vitamin D analog use. The focus of treatment for CKD patients with hypertension is on controlling blood pressure, and vitamin D may have a secondary role in this process. Overall, the most appropriate use of vitamin D analogs in CKD is for the management of secondary hyperparathyroidism.