Abstract. Low extracellular calcium (Ca) stimulates parathyroid hormone (PTH) secretion and also increases the renal synthesis of calcitriol (CTR), which is known to decrease PTH production. This study began with the hypothesis that the parathyroid cell response to CTR may be modulated by extracellular Ca concentration through an effect on parathyroid cell vitamin D receptor (VDR). In the present study, rat parathyroid glands were incubated in low (0.6 mM) and high (1.5 mM) Ca concentration. The parathyroid VDRmRNA was higher in 1.5 than 0.6 mM Ca. Furthermore, this effect was not observed in incubated slices of kidney cortex and medulla, tissues which also possess both Ca and vitamin D receptors. Experiments were also performed to evaluate the effect of Ca on VDR expression in vivo. Male Wistar rats received intraperitoneal injections of CaCl 2 or a single intramuscular injection of EDTA to obtain 6 h of hypercalcemic (ionized Ca, 1.4 to 1.6 mM) or hypocalcemic (ionized Ca, 0.85 to 0.95 mM) clamp; a third group of rats was used as control. A small dose of CTR was administered to hypercalcemic rats to match the serum CTR levels of hypocalcemic rats. Parathyroid gland VDRm-RNA and VDR protein were increased in hypercalcemic rats as compared with hypocalcemic rats. Increasing doses of CTR upregulated VDRmRNA and VDR only in hypercalcemic rats. Additional experiments showed that the decrease in VDR in hypocalcemic rats prevented the inhibitory effect of CTR on PTHmRNA. In conclusion, our study shows that extracellular Ca regulates VDR expression by parathyroid cells independently of CTR and that by this mechanism hypocalcemia may prevent the feedback of CTR on the parathyroids.The parathyroid cell increases parathyroid hormone (PTH) secretion in response to a decrease in the extracellular calcium (Ca) concentration. A cell membrane Ca sensor receptor enables these cells to respond to small changes in serum Ca concentration (1). PTH acts on its target organs, mainly kidney and bone, to increase the serum Ca to its normal level. Calcitriol (CTR), the production of which is stimulated by hypocalcemia and also by PTH, is another hormone that contributes to restoration of normocalcemia by stimulating intestinal absorption of Ca (2). Thus there are two different hormones, PTH and CTR, with a calcemic effect, and both share the commitment of preserving normocalcemia. The elevation of serum Ca feeds back on the parathyroid cell, inhibiting PTH secretion and synthesis (2); in addition, high CTR also inhibits PTH synthesis by acting on specific vitamin D receptors (VDR) (3). The inhibitory effect of CTR on parathyroid cells has been widely demonstrated to the point that CTR is used to reduce PTH levels in uremic patients with advanced hyperparathyroidism (4). However, it would not seem appropriate that CTR should inhibit PTH synthesis if hypocalcemia persists; such inhibition would counteract the function of the parathyroid cell, which is to restore normocalcemia. Furthermore, it would seem paradoxical that the parathyroid c...