The therapeutic potential of C-peptide in kidney disease: a protocol for a systematic review and meta-analysis
Tóm tắt
Kidney disease remains a major cause of morbidity and mortality in Canada and worldwide. New medical treatments are needed to reduce the progression of kidney disease to improve patient outcomes. C-peptide is normally released by pancreatic beta-cells along with insulin in healthy individuals, and has been shown to have intrinsic biological activity and to potentially be renoprotective. The effect of exogenous C-peptide on kidney structure and function, and the role of C-peptide in the treatment of kidney disease have not yet been fully elucidated. We will conduct a systematic review of the literature in human clinical trials and mammalian experimental models to ascertain the current evidence for the role of C-peptide as a potential therapeutic agent for the treatment of kidney disease. We aim to identify whether exogenously delivered C-peptide has an effect on clinically relevant outcomes such as glomerular filtration rate, proteinuria, kidney histology, requirement of renal replacement therapy, and mortality. We will search MEDLINE, EMBASE, and the Cochrane Central Databases for human or animal studies in which C-peptide was administered and renal endpoints were subsequently measured. Study quality will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias. If appropriate, a meta-analysis will be performed as per standard techniques. The results of this study will determine the potential role of C-peptide as a therapeutic intervention for patients with kidney disease and will help guide subsequent clinical trials. The study may also provide insight into which patients or disease states are likely to benefit the most from C-peptide. PROSPERO
CRD42014007472
Tài liệu tham khảo
Arora P, Vasa P, Brenner D, Iglar K, McFarlane P, Morrison H, Badawi A: Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey. Can Med Assoc J. 2013, 185: E417-E423. 10.1503/cmaj.120833.
Coresh J, Selvin E, Stevens L, Manzi J, Kusek J, Eggers P, Van Lente F, Levey A: Prevalence of chronic kidney disease in the United States. JAMA. 2007, 298: 2038-2047. 10.1001/jama.298.17.2038.
Honeycutt A, Segel J, Zhuo X, Hoerger T, Imai K, Williams D: Medical costs of CKD in the Medicare population. J Am Soc Nephrol. 2013, 24: 1478-1483. 10.1681/ASN.2012040392.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group: KDIGO clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013, 3: 1-150.
National Kidney F: KDOQI Clinical Practice Guideline for Diabetes and CKD: 2012 Update. Am J Kidney Dis. 2012, 60: 850-886.
Williams ME: Diabetic CKD/ESRD 2010: a progress report?. Semin Dial. 2010, 23: 129-133. 10.1111/j.1525-139X.2009.00698.x.
Chan SJ, Keim P, Steiner DF: Cell-free synthesis of rat preproinsulins: characterization and partial amino acid sequence determination. Proc Natl Acad Sci U S A. 1976, 73: 1964-1968. 10.1073/pnas.73.6.1964.
Steiner DF, Cunningham D, Spigelman L, Aten B: Insulin biosynthesis: evidence for a precursor. Science. 1967, 157: 697-700. 10.1126/science.157.3789.697.
Clark JL, Steiner DF: Insulin biosynthesis in the rat: demonstration of two proinsulins. Proc Natl Acad Sci U S A. 1969, 62: 278-285. 10.1073/pnas.62.1.278.
Horwitz DL, Starr JI, Mako ME, Blackard WG, Rubenstein AH: Proinsulin, insulin, and C-peptide concentrations in human portal and peripheral blood. J Clin Invest. 1975, 55: 1278-1283. 10.1172/JCI108047.
Wahren J, Ekberg K, Jornvall H: C-peptide is a bioactive peptide. Diabetologia. 2007, 50: 503-509.
Bo S, Gentile L, Castiglione A, Prandi V, Canil S, Ghigo E, Ciccone G: C-peptide and the risk for incident complications and mortality in type 2 diabetic patients: a retrospective cohort study after a 14-year follow-up. Eur J Endocrinol. 2012, 167: 173-180.
Panero F, Novelli G, Zucco C, Fornengo P, Perotto M, Segre O, Grassi G, Cavallo Perin P, Bruno G: Fasting plasma C-peptide and micro- and macrovascular complications in a large clinic-based cohort of type 1 diabetic patients. Diabetes Care. 2009, 32: 301-305.
Kim B-Y, Jung C-H, Mok J-O, Kang S-K, Kim C-H: Association between serum C-peptide levels and chronic microvascular complications in Korean type 2 diabetic patients. Acta Diabetol. 2012, 49: 9-15. 10.1007/s00592-010-0249-6.
Zheng WC, Chen L: Factor analysis of diabetic nephropathy in Chinese patients. Diabetes Metab Syndr. 2011, 5: 130-136. 10.1016/j.dsx.2012.02.018.
Luppi P, Kallas A, Wahren J: Can C-peptide mediated anti-inflammatory effects retard the development of microvascular complications of type 1 diabetes?. Diabetes Metab Res. 2013, 29: 357-362. 10.1002/dmrr.2409.
Boggi U, Vistoli F, Amorese G, Giannarelli R, Coppelli A, Mariotti R, Rondinini L, Barsotti M, Piaggesi A, Tedeschi A, Signori S, De Lio N, Occhipinti M, Mangione E, Cantarovich D, Del Prato S, Mosca F, Marchetti P: Results of pancreas transplantation alone with special attention to native kidney function and proteinuria in type 1 diabetes patients. Rev Diabet Stud. 2011, 8: 259-267. 10.1900/RDS.2011.8.259.
Cantarovich D, Perrone V: Pancreas transplant as treatment to arrest renal function decline in patients with type 1 diabetes and proteinuria. Semin Nephrol. 2012, 32: 432-436. 10.1016/j.semnephrol.2012.07.005.
Johansson B, Kernell A, Sjoberg S, Wahren J: Influence of combined C-peptide and insulin administration on renal function and metabolic control in diabetes type 1. J Clin Endocrinol Metab. 1993, 77: 976-981.
Johansson B, Borg K, Fernqvist-Forbes E, Kernell A, Odergren T, Wahren J: Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus. Diabetic Med. 2000, 17: 181-189. 10.1046/j.1464-5491.2000.00274.x.