C-peptide and diabetic kidney disease

Area of Science:

• Nephrology
• Endocrinology
• Diabetology

Background:

• Diabetic kidney disease (DKD) is a major complication of diabetes mellitus with no new treatments in 20 years.
• Evidence suggests C-peptide plays a biological role in metabolic and pathophysiological pathways of DKD.
• C-peptide's renoprotective effects are indicated in animal models and human studies.

Purpose of the Study:

• To review the evidence for C-peptide's beneficial effects on diabetic nephropathy.
• To support the rationale for clinical trials of C-peptide in DKD.

Main Methods:

• Review of studies involving C-peptide in animal models of diabetes.
• Analysis of cohort studies in diabetic patients with transplants.
• Examination of short-term clinical studies administering C-peptide to type 1 diabetes patients.

Main Results:

• C-peptide reduced glomerular hyperfiltration and albuminuria in diabetic rodents.
• Maintained C-peptide secretion correlated with protective renal graft function in transplant patients.
• C-peptide administration lowered hyperfiltration and microalbuminuria in type 1 diabetes patients.

Conclusions:

• Type 1 diabetes may be viewed as a dual hormone deficiency.
• C-peptide demonstrates potential renoprotective effects in diabetes.
• Clinical trials of C-peptide for diabetic nephropathy are warranted.