Prospective Double Blind Multicentre Randomized Trial of Vitamine D Estimating the Profit of a Treatment by Vitamin D3 at the Dose of 100000 UI by Comparison With a Treatment in the Dose of 12 000 UI at Renal Transplanted Patients
Vitamin D cannot be considered any more as only necessary to prevent rickets or
osteomalacia. Calcitriol produced in the kidney is known to have classical endocrine
PHOSPHOCALCIC properties. More recently, vitamin D has been shown to play an important role
in reducing the risk of many chronic diseases including type 2 diabetes mellitus,
cardiovascular diseases, cancers, autoimmune and infectious diseases. These effects may be
secondary to local production of calcitriol and to its autocrine and paracrine actions on
cellular proliferation and differentiation, apoptosis, insulin and renin secretion,
interleukin and bactericidal proteins production. These pleiotropic effects are mostly
documented by observational and experimental studies or small intervention trials that most
often evaluated intermediate parameters. In renal transplant recipients, vitamin D
insufficiency (circulating 25OHD<30 ng/mL or 75 nmol/L) , is a frequent finding with more
than 80% of patients displaying this profile.
Primary objective: compare the effects of high dose vs. low dose of cholecalciferol on a
composite endpoint including
- De novo diabetes mellitus (fasting glycemia > 7 MMOLES/l or glycemia > 11 MMOLES/l)
- Cardiovascular complications (acute coronary heart disease, acute heart failure,
lower-extremity arterial disease, cerebrovascular disease).
- De novo cancer,
- Patient death.
Secondary objectives : compare the effects of high dose vs. low dose of cholecalciferol on
- Blood pressure and blood pressure control (number and dosage of antihypertensive drugs)
- Echocardiography findings
- Infection including opportunistic (CMV, pneumocystis, nocardial infection, cryptococcal
- Acute rejection episode
- Renal allograft function including estimated glomerular filtration rate and proteinuria
- Graft survival
- PHOSPHOCALCIC biological and clinical relevant parameters : Evolution of serum 25OHD,
calcaemia, phosphataemia, serum PTH, bone mineral density and incidence of fractures
- Renal lithiasis
Number of patients: 320 patients in each group Inclusions : 1 year Follow-up after inclusion
: 2 years Prospective, randomized, multicentre, double blind clinical study comparing high
dose cholecalciferol [100 000 UI FORTHIGHTLY for 2 months then monthly for 22 months) vs.
low dose cholecalciferol [12 000 UI FORTHIGHTLY for 2 months then monthly for 22 months).
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
De novo diabetes mellitus
De novo diabetes mellitus (fasting glycemia > 7 mmoles/l or glycemia > 11 mmoles/l)
European Georges Pompidou Hospital
France: Ministry of Health