C-peptide as a Therapy for XXXX : A Systematic Review and Meta-Analysis.

@entity1 @entity644 @entity8 @entity6 @entity1009 @entity740 @entity633 @entity413
UNASSIGNED: C-peptide has intrinsic biological activity and may be renoprotective. We conducted a systematic review to determine whether C-peptide had a beneficial effect on renal outcomes. MEDLINE, EMBASE, and the Cochrane Central Databases were searched for @entity1 and animal studies in which C-peptide was administered and renal endpoints were subsequently measured. We identified 4 @entity1 trials involving 74 @entity1 as well as 18 animal studies involving 35 separate experiments with a total of 641 animals. In @entity1 , the renal effects of exogenously delivered C-peptide were only studied in type 1 diabetics with either normal renal function or incipient @entity8 . Pooled analysis showed no difference in GFR (mean difference, -1.36 mL/ @entity1009 .73 m2, p = 0.72) in @entity1 receiving C-peptide compared to a control group, but two studies reported a reduction in glomerular hyperfiltration (p<0.05). Reduction in @entity633 was also reported in the C-peptide group (p<0.05). In @entity6 rodent models, C-peptide led to a reduction in GFR (mean difference, -0.62 mL/min, p<0.00001) reflecting a partial reduction in glomerular hyperfiltration. C-peptide also reduced @entity644 (mean difference, -186.25 mg/day, p = 0.05), glomerular volume (p<0.00001), and mesangial matrix area (p<0.00001) in @entity6 animals without affecting blood pressure or plasma @entity413 . Most studies were relatively short-term in duration, ranging from 1 hour to 3 months. @entity1 studies of sufficient sample size and duration are needed to determine if the beneficial effects of C-peptide seen in animal models translate into improved long-term clinical outcomes for @entity1 with @entity740 . (PROSPERO CRD42014007472).
